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                                                <option>男</option>
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                                                <option>是</option>
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                                            <span class="input-title">特病</span>
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                                                <option>是</option>
                                                <option>否</option>
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                                                <option value="汉族">汉族</option>
                                                <option value="蒙古族">蒙古族</option>
                                                <option value="回族">回族</option>
                                                <option value="藏族">藏族</option>
                                                <option value="维吾尔族">维吾尔族</option>
                                                <option value="苗族">苗族</option>
                                                <option value="彝族">彝族</option>
                                                <option value="壮族">壮族</option>
                                                <option value="布依族">布依族</option>
                                                <option value="朝鲜族">朝鲜族</option>
                                                <option value="满族">满族</option>
                                                <option value="侗族">侗族</option>
                                                <option value="瑶族">瑶族</option>
                                                <option value="白族">白族</option>
                                                <option value="土家族">土家族</option>
                                                <option value="哈尼族">哈尼族</option>
                                                <option value="哈萨克族">哈萨克族</option>
                                                <option value="傣族">傣族</option>
                                                <option value="黎族">黎族</option>
                                                <option value="傈僳族">傈僳族</option>
                                                <option value="佤族">佤族</option>
                                                <option value="畲族">畲族</option>
                                                <option value="高山族">高山族</option>
                                                <option value="拉祜族">拉祜族</option>
                                                <option value="水族">水族</option>
                                                <option value="东乡族">东乡族</option>
                                                <option value="纳西族">纳西族</option>
                                                <option value="景颇族">景颇族</option>
                                                <option value="柯尔克孜族">柯尔克孜族</option>
                                                <option value="土族">土族</option>
                                                <option value="达斡尔族">达斡尔族</option>
                                                <option value="仫佬族">仫佬族</option>
                                                <option value="羌族">羌族</option>
                                                <option value="布朗族">布朗族</option>
                                                <option value="撒拉族">撒拉族</option>
                                                <option value="毛南族">毛南族</option>
                                                <option value="仡佬族">仡佬族</option>
                                                <option value="锡伯族">锡伯族</option>
                                                <option value="阿昌族">阿昌族</option>
                                                <option value="普米族">普米族</option>
                                                <option value="塔吉克族">塔吉克族</option>
                                                <option value="怒族">怒族</option>
                                                <option value="乌孜别克族">乌孜别克族</option>
                                                <option value="俄罗斯族">俄罗斯族</option>
                                                <option value="鄂温克族">鄂温克族</option>
                                                <option value="德昂族">德昂族</option>
                                                <option value="保安族">保安族</option>
                                                <option value="裕固族">裕固族</option>
                                                <option value="京族">京族</option>
                                                <option value="塔塔尔族">塔塔尔族</option>
                                                <option value="独龙族">独龙族</option>
                                                <option value="鄂伦春族">鄂伦春族</option>
                                                <option value="赫哲族">赫哲族</option>
                                                <option value="门巴族">门巴族</option>
                                                <option value="珞巴族">珞巴族</option>
                                                <option value="基诺族">基诺族</option>
                                            </select>
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                                        <div id="distpicker">
                                            <div class="col-xs-3 margin-top-15">
                                                <span class="input-title">省份</span>
                                                <select class="form-control" id="province"></select>
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                                                <span class="input-title">城市</span>
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                                            <button type="button" class="btn btn-primary btn-lg">保存</button>
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        <div class="row">
            <div class="col-xs-12">
                <!-- Nav tabs -->
                <ul class="nav nav-tabs" role="tablist">
                    <li class="active"><a href="#suizhen"  data-toggle="tab">随诊</a></li>
                    <li><a href="#tigejiancha"  data-toggle="tab">体格检查</a></li>
                    <li><a href="#fuzhujiancha"  data-toggle="tab">辅助检查</a></li>
                    <li><a href="#zhenduan"  data-toggle="tab">诊断</a></li>
                    <li><a href="#chuli"  data-toggle="tab">处理</a></li>
                </ul>

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                <div class="tab-content">
                    <!--随诊-->
                    <div class="tab-pane active" id="suizhen">
                        <div class="row margin-top-15 input-box-one">
                            <div class="col-xs-3">
                                <span class="input-title">起病日期</span>
                                <input type="text" name="doctordate" class="form-control input-content" data-toggle="datepicker" placeholder="请输入起病日期">
                            </div>
                            <div class="col-xs-3">
                                <span class="input-title-position">医院</span>
                                <select class="form-control m-b input-content margin-bottom-0" name="sceneid">
                                    <option value="1">1</option>
                                    <option value="2">2</option>
                                    <option value="3">3</option>
                                    <option value="5">4</option>
                                </select>
                            </div>
                            <div class="col-xs-3">
                                <span class="input-title-position">医生</span>
                                <select class="form-control m-b input-content margin-bottom-0" name="doctorid">
                                    <option value="1">1</option>
                                    <option value="2">2</option>
                                    <option value="3">3</option>
                                    <option value="5">4</option>
                                </select>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>随诊</span>
                            </div>
                        </div>
                        <div>
                            <div class="row margin-top-15 input-box-one">
                                <div class="col-xs-3">
                                    <span class="input-title">起病日期</span>
                                    <input type="text" name="onsetdate" class="form-control input-content" data-toggle="datepicker" placeholder="请输入起病日期">
                                </div>
                                <div class="col-xs-3">
                                    <span class="input-title-position">诱因</span>
                                    <select class="form-control m-b input-content margin-bottom-0" name="causeid">
                                        <option value="1">无明显诱因</option>
                                        <option value="2">情绪波动</option>
                                        <option value="3">工作压力大</option>
                                        <option value="5">其他</option>
                                    </select>
                                </div>
                                <div class="col-xs-3">
                                    <span class="input-title">就诊地点</span>
                                    <input type="text" placeholder="20个字以内" name="causeremark" class="form-control input-content" maxlength="20">
                                </div>
                                <div class="col-xs-3">
                                    <span class="input-title-position">起病症状</span>
                                    <button type="button" class="btn btn-primary btn-outline" data-toggle="modal" data-target="#addSymptom">添加主要症状</button>
                                </div>
                            </div>
                            <div class="row margin-top-15 xbs-input-two">
                                <div class="col-xs-12">
                                    <span class="xbs-input-title">用药前化验</span>
                                    <div class="xbs-input-box">
                                        <span>空腹血糖</span>
                                        <div class="input-content">
                                            <input type="number" name="before_n_glood_low" class="form-control">
                                            <span>-</span>
                                            <input type="number" name="before_n_glood_high" class="form-control">
                                            <span>mmol/L</span>
                                        </div>
                                    </div>
                                    <div class="xbs-input-box">
                                        <span>餐后2h血糖</span>
                                        <div class="input-content">
                                            <input type="number" name="before_d_glood_low" class="form-control">
                                            <span>-</span>
                                            <input type="number" name="before_d_glood_high" class="form-control">
                                            <span>mmol/L</span>
                                        </div>
                                    </div>
                                    <div class="xbs-input-box">
                                        <span>HbA1c</span>
                                        <div class="input-content">
                                            <input type="number" name="hba1c" class="form-control">
                                            <span>mmol/L</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="col-xs-12 margin-top-15">
                                    <span class="xbs-input-title">治疗后血糖值</span>
                                    <div class="xbs-input-box">
                                        <span>空腹血糖</span>
                                        <div class="input-content">
                                            <input type="number" name="after_n_glood_low" class="form-control">
                                            <span>-</span>
                                            <input type="number" name="after_n_glood_high" class="form-control">
                                            <span>mmol/L</span>
                                        </div>
                                    </div>
                                    <div class="xbs-input-box">
                                        <span>餐后2h血糖</span>
                                        <div class="input-content">
                                            <input type="number" name="after_d_glood_low" class="form-control">
                                            <span>-</span>
                                            <input type="number" name="after_d_glood_high" class="form-control">
                                            <span>mmol/L</span>
                                        </div>
                                    </div>
                                </div>
                            </div>

                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <button type="button" class="btn btn-primary btn-outline btn-lg" data-toggle="modal" data-target="#addDiagnosis">添加诊断</button>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <table class="table-bordered table-striped table-hover text-center diagnosis-table">
                                        <thead>
                                        <tr>
                                            <th>病名</th>
                                            <th>ICD编码</th>
                                            <th>操作</th>
                                        </tr>
                                        </thead>
                                        <tbody>
                                        <tr>
                                            <td>高血压病</td>
                                            <td>E10.951</td>
                                            <td><button type="button" class="btn btn-outline btn-danger">删除</button></td>
                                        </tr>
                                        <tr>
                                            <td>高血压病</td>
                                            <td>E10.951</td>
                                            <td><button type="button" class="btn btn-outline btn-danger">删除</button></td>
                                        </tr>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <button type="button" class="btn btn-outline btn-primary btn-lg" data-toggle="modal" data-target="#addMedication">添加用药</button>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <table class="table-bordered table-striped table-hover text-center medicationList-table">
                                        <thead>
                                        <tr>
                                            <th>开始时间</th>
                                            <th>结束时间</th>
                                            <th>名称</th>
                                            <th>剂量</th>
                                            <th>单位</th>
                                            <th>用法</th>
                                            <th>频次</th>
                                            <th>其他备注</th>
                                            <th>操作</th>
                                        </tr>
                                        </thead>
                                        <tbody>
                                        <tr>
                                            <td>2017-06-02</td>
                                            <td>2017-06-02</td>
                                            <td>格华止</td>
                                            <td>9</td>
                                            <td>mg</td>
                                            <td>口服</td>
                                            <td>qd</td>
                                            <td>999</td>
                                            <td>
                                                <button type="button" class="btn btn-outline btn-primary"  data-toggle="modal" data-target="#addMedication">编辑</button>
                                                <button type="button" class="btn btn-outline btn-danger">删除</button>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td>2017-06-02</td>
                                            <td>2017-06-02</td>
                                            <td>格华止</td>
                                            <td>9</td>
                                            <td>mg</td>
                                            <td>口服</td>
                                            <td>qd</td>
                                            <td>999</td>
                                            <td>
                                                <button type="button" class="btn btn-outline btn-primary"  data-toggle="modal" data-target="#addMedication">编辑</button>
                                                <button type="button" class="btn btn-outline btn-danger">删除</button>
                                            </td>
                                        </tr>
                                        </tbody>
                                    </table>
                                </div>
                            </div>

                            <!--中医部分 start-->
                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <button type="button" class="btn btn-outline btn-primary btn-lg" data-toggle="modal" data-target="#addTcm">添加汤药</button>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <table class="table-bordered table-striped table-hover text-center tcm-table">
                                        <thead>
                                        <tr>
                                            <th>名称剂量</th>
                                            <th>煎服方法</th>
                                            <th>操作</th>
                                        </tr>
                                        </thead>
                                        <tbody>
                                        <tr>
                                            <td>闹羊花 1g</td>
                                            <td>煎法：水煎服 频次：一日一剂，两次分服 总数：3付</td>
                                            <td>
                                                <button type="button" class="btn btn-outline btn-primary"  data-toggle="modal" data-target="#addTcm">编辑</button>
                                                <button type="button" class="btn btn-outline btn-danger">删除</button>
                                            </td>
                                        </tr>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                            <!--中医部分 end-->

                            <div class="row margin-top-15">
                                <div class="col-xs-12">
                                    <button type="button" class="btn btn-outline btn-primary btn-lg">追加一组随诊</button>
                                </div>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>自我血糖监测情况</span>
                            </div>
                        </div>
                        <div class="row margin-top-15 xbs-input-two">
                            <div class="col-xs-12">
                                <span class="xbs-input-title">血糖值</span>
                                <div class="xbs-input-box">
                                    <span>空腹血糖</span>
                                    <div class="input-content">
                                        <input type="number" name="fastingblood" class="form-control">
                                        <span>-</span>
                                        <input type="number" name="endfastingblood" class="form-control">
                                        <span>mmol/L</span>
                                    </div>
                                </div>
                                <div class="xbs-input-box">
                                    <span>餐后血糖</span>
                                    <div class="input-content">
                                        <input type="number" name="afterblood" class="form-control">
                                        <span>-</span>
                                        <input type="number" name="endafterblood" class="form-control">
                                        <span>mmol/L</span>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">监测血糖</button>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>上次就诊至本次就诊间隔情况评价</span>
                            </div>
                        </div>
                        <div class="row margin-top-15 follow-evaluation">
                            <div class="col-xs-4">
                                <span class="evaluation-title">血糖情况</span>
                                <div class="evaluation-content">
                                    <label><input type="radio" name="bloodSugar" checked>控制良好</label>
                                    <label><input type="radio" name="bloodSugar">控制不佳</label>
                                </div>
                            </div>
                            <div class="col-xs-4">
                                <span class="evaluation-title">体重变化</span>
                                <div class="evaluation-content">
                                    <select class="form-control m-b margin-bottom-0" name="weightChange">
                                        <option value="1">无变化</option>
                                        <option value="2">下降</option>
                                        <option value="3">上升</option>
                                    </select>
                                    <select class="form-control m-b margin-bottom-0" name="weightChangeVal">
                                        <option value="1">明显</option>
                                        <option value="2">不明显</option>
                                    </select>
                                </div>
                            </div>
                            <div class="col-xs-4">
                                <span class="evaluation-title">低血糖发作</span>
                                <div class="evaluation-content">
                                    <label><input type="radio" name="lowBloodSugar" checked>无</label>
                                    <label><input type="radio" name="lowBloodSugar">反复</label>
                                    <label><input type="radio" name="lowBloodSugar">偶尔</label>
                                </div>
                            </div>
                        </div>
                        <div class="row margin-top-15 follow-evaluation">
                            <div class="col-xs-4">
                                <span class="evaluation-title">评价备注</span>
                                <div class="evaluation-content">
                                    <input type="text" class="form-control bloodSugarNote" name="bloodSugarNote">
                                </div>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>上次就诊至本次就诊间隔症状</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-10">
                                <button type="button" class="btn btn-primary btn-outline btn-lg" data-toggle="modal" data-target="#addSymptom">添加主要症状</button>
                            </div>
                            <!--主要症状标签列表-->
                            <div class="col-xs-12 margin-top-10 symptomList">
                                <h3>主要症状：</h3>
                                <ul class="sui-tag">
                                    <li class="tag-selected with-x">单侧下肢皮肤瘙痒<i>×</i></li>
                                    <li class="tag-selected with-x">单侧下肢皮肤瘙痒<i>×</i></li>
                                    <li class="tag-selected with-x">单侧下肢皮肤瘙痒<i>×</i></li>
                                    <li class="tag-selected with-x">单侧下肢皮肤瘙痒<i>×</i></li>
                                    <li class="tag-selected with-x">单侧下肢皮肤瘙痒<i>×</i></li>
                                </ul>
                            </div>
                        </div>
                        <div class="row margin-top-15 follow-evaluation">
                            <div class="col-xs-4">
                                <span class="symptoms-title">症状备注</span>
                                <input type="text" class="form-control symptomsNote" name="symptomsNote">
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>添加用药</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-outline btn-primary btn-lg" data-toggle="modal" data-target="#addMedication">添加用药</button>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center medicationList-table">
                                    <thead>
                                    <tr>
                                        <th>开始时间</th>
                                        <th>结束时间</th>
                                        <th>名称</th>
                                        <th>剂量</th>
                                        <th>单位</th>
                                        <th>用法</th>
                                        <th>频次</th>
                                        <th>其他备注</th>
                                        <th>操作</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>2017-06-02</td>
                                        <td>2017-06-02</td>
                                        <td>格华止</td>
                                        <td>9</td>
                                        <td>mg</td>
                                        <td>口服</td>
                                        <td>qd</td>
                                        <td>999</td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-primary"  data-toggle="modal" data-target="#addMedication">编辑</button>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>2017-06-02</td>
                                        <td>2017-06-02</td>
                                        <td>格华止</td>
                                        <td>9</td>
                                        <td>mg</td>
                                        <td>口服</td>
                                        <td>qd</td>
                                        <td>999</td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-primary"  data-toggle="modal" data-target="#addMedication">编辑</button>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>一般情况</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="xbs-table">
                                    <tbody>
                                    <tr>
                                        <td class="jzs-border-bottom bg-default">患者每天</td>
                                        <td class="jzs-border-lr jzs-border-bottom">
                                            <div class="input-content">
                                                <span>主食</span>
                                                <input type="number" placeholder="请填写主食重量" name="staplefood" class="form-control input-content-center">
                                                <span class="text-left">g</span>
                                            </div>
                                            <div class="margin-top-15">
                                                <div class="xgb-foods-type">
                                                    <span>肉类</span>
                                                    <input name="solidfood" type="radio" value="多"/>多
                                                    <input name="solidfood" type="radio" value="适量" checked/>适量
                                                    <input name="solidfood" type="radio" value="少"/>少
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>油脂</span>
                                                    <input name="grease" type="radio" value="多"/>多
                                                    <input name="grease" type="radio" value="适量" checked/>适量
                                                    <input name="grease" type="radio" value="少"/>少
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>素菜</span>
                                                    <input name="vegetable" type="radio" value="多"/>多
                                                    <input name="vegetable" type="radio" value="适量" checked/>适量
                                                    <input name="vegetable" type="radio" value="少"/>少
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>水果</span>
                                                    <input name="fruits" type="radio" value="多"/>多
                                                    <input name="fruits" type="radio" value="适量" checked/>适量
                                                    <input name="fruits" type="radio" value="少"/>少
                                                </div>
                                            </div>
                                        </td>
                                        <td class="bg-default" rowspan="2">患者其他情况</td>
                                        <td class="jzs-border-lr" rowspan="2">
                                            <div class="margin-top-15">
                                                <div class="xgb-foods-type">
                                                    <span>饮食</span>
                                                    <input name="appetite" type="radio" value="佳" checked/>佳
                                                    <input name="appetite" type="radio" value="尚可"/>尚可
                                                    <input name="appetite" type="radio" value="欠佳"/>欠佳
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>睡眠</span>
                                                    <input name="sleep" type="radio" value="佳" checked/>佳
                                                    <input name="sleep" type="radio" value="尚可"/>尚可
                                                    <input name="sleep" type="radio" value="欠佳"/>欠佳
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>精神</span>
                                                    <input name="spirit" type="radio" value="佳" checked/>佳
                                                    <input name="spirit" type="radio" value="尚可"/>尚可
                                                    <input name="spirit" type="radio" value="欠佳"/>欠佳
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>情绪</span>
                                                    <input name="mood" type="radio" value="佳" checked/>佳
                                                    <input name="mood" type="radio" value="尚可"/>尚可
                                                    <input name="mood" type="radio" value="欠佳"/>欠佳
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>大便</span>
                                                    <input name="shit" type="radio" value="正常" checked/>正常
                                                    <input name="shit" type="radio" value="便秘"/>便秘
                                                    <input name="shit" type="radio" value="腹泻"/>腹泻
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>备注</span>
                                                    <input type="text" name="shitremark" class="form-control shitremark" placeholder="请填写大便备注">
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>小便(夜)</span>
                                                    <select class="form-control m-b urine-select" name="urine">
                                                        <option value="0次">0次</option>
                                                        <option value="1次">1次</option>
                                                        <option value="1~2次">1~2次</option>
                                                        <option value="2~3次">2~3次</option>
                                                        <option value="3~5次">3~5次</option>
                                                        <option value="5次以上">5次以上</option>
                                                    </select>
                                                </div>
                                                <div class="xgb-foods-type">
                                                    <span>备注</span>
                                                    <input type="text" name="urineremark" class="form-control shitremark" placeholder="请填写小便(夜)备注">
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td class="bg-default">患者运动</td>
                                        <td class="jzs-border-lr">
                                            <select class="form-control m-b sport-select" name="sportsituation">
                                                <option value="0">不运动</option>
                                                <option value="1">运动少</option>
                                                <option value="2">偶尔运动</option>
                                                <option value="3">每天30-60分钟</option>
                                                <option value="4">每天60分钟以上</option>
                                            </select>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--备注-->
                        <div class="row margin-top-20">
                            <div class="col-xs-12 weight-change">
                                <span class="weight-title">备注信息</span>
                                <textarea name="" rows="10"></textarea>
                            </div>
                        </div>
                        <!--保存按钮-->
                        <div class="row margin-top-20">
                            <div class="col-xs-6 text-right">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存</button>
                            </div>
                            <div class="col-xs-6">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存并下一步</button>
                            </div>
                        </div>
                    </div>
                    <!--体格检查-->
                    <div class="tab-pane" id="tigejiancha">
                        <!--中医部分 start-->
                        <div class="row">
                            <div class="col-xs-12 xbs-separated">
                                <span>舌像</span>
                            </div>
                        </div>
                        <div class="margin-bottom-20 tgjc-border-bottom">
                            <div class="row margin-top-15 margin-bottom-15">
                                <div class="col-xs-12">
                                    <table class="table-bordered text-center tongue-table">
                                        <tbody>
                                        <tr>
                                            <td class="tongue-name bg-default">舌色</td>
                                            <td>
                                                <label><input type="radio" name="tongueColor" value="淡红舌">淡红舌</label>
                                                <label><input type="radio" name="tongueColor" value="淡白舌">淡白舌</label>
                                                <label><input type="radio" name="tongueColor" value="枯白舌">枯白舌</label>
                                                <label><input type="radio" name="tongueColor" value="红舌">红舌</label>
                                                <label><input type="radio" name="tongueColor" value="絳舌">絳舌</label>
                                                <label><input type="radio" name="tongueColor" value="青紫舌">青紫舌</label>
                                                <label><input type="radio" name="tongueColor" value="淡紫舌">淡紫舌</label>
                                            </td>
                                            <td class="tongue-name bg-default">舌态</td>
                                            <td>
                                                <label><input type="radio" name="tongueState" value="痿软舌">痿软舌</label>
                                                <label><input type="radio" name="tongueState" value="强硬舌">强硬舌</label>
                                                <label><input type="radio" name="tongueState" value="歪斜舌">歪斜舌</label>
                                                <label><input type="radio" name="tongueState" value="短缩舌">短缩舌</label>
                                                <label><input type="radio" name="tongueState" value="颤动舌">颤动舌</label>
                                                <label><input type="radio" name="tongueState" value="吐弄舌">吐弄舌</label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="tongue-name bg-default">舌型</td>
                                            <td>
                                                <label><input type="radio" name="tongueType" value="老舌">老舌</label>
                                                <label><input type="radio" name="tongueType" value="嫩舌">嫩舌</label>
                                                <label><input type="radio" name="tongueType" value="胖大舌">胖大舌</label>
                                                <label><input type="radio" name="tongueType" value="瘦薄舌">瘦薄舌</label>
                                                <label><input type="radio" name="tongueType" value="点舌">点舌</label>
                                                <label><input type="radio" name="tongueType" value="刺舌">刺舌</label>
                                                <label><input type="radio" name="tongueType" value="裂纹舌">裂纹舌</label>
                                                <label><input type="radio" name="tongueType" value="齿痕舌">齿痕舌</label>
                                            </td>
                                            <td class="tongue-name bg-default">舌下脉络</td>
                                            <td>
                                                <label><input type="radio" name="tongueVein" value="舌下络脉青紫">舌下络脉青紫</label>
                                                <label><input type="radio" name="tongueVein" value="舌下静脉曲张">舌下静脉曲张</label>
                                                <label><input type="radio" name="tongueVein" value="舌下脉络细短">舌下脉络细短</label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="tongue-name bg-default">舌苔</td>
                                            <td>
                                                <label><input type="radio" name="tongueCoating" value="薄苔">薄苔</label>
                                                <label><input type="radio" name="tongueCoating" value="厚苔">厚苔</label>
                                                <label><input type="radio" name="tongueCoating" value="润苔">润苔</label>
                                                <label><input type="radio" name="tongueCoating" value="滑苔">滑苔</label>
                                                <label><input type="radio" name="tongueCoating" value="燥苔">燥苔</label>
                                                <label><input type="radio" name="tongueCoating" value="糙苔">糙苔</label>
                                                <label><input type="radio" name="tongueCoating" value="腻苔">腻苔</label>
                                                <label><input type="radio" name="tongueCoating" value="腐苔">腐苔</label>
                                                <label><input type="radio" name="tongueCoating" value="中剥苔">中剥苔</label>
                                                <label><input type="radio" name="tongueCoating" value="后剥苔">后剥苔</label>
                                                <label><input type="radio" name="tongueCoating" value="花剥苔">花剥苔</label>
                                                <label><input type="radio" name="tongueCoating" value="类剥苔">类剥苔</label>
                                                <label><input type="radio" name="tongueCoating" value="镜面苔">镜面苔</label>
                                                <label><input type="radio" name="tongueCoating" value="有根苔(真苔)">有根苔(真苔)</label>
                                                <label><input type="radio" name="tongueCoating" value="无根苔(假苔)">无根苔(假苔)</label>
                                            </td>
                                            <td class="tongue-name bg-default">苔色</td>
                                            <td>
                                                <label><input type="radio" name="mossColor " value="白苔">白苔</label>
                                                <label><input type="radio" name="mossColor " value="积粉苔">积粉苔</label>
                                                <label><input type="radio" name="mossColor " value="黄苔">黄苔</label>
                                                <label><input type="radio" name="mossColor " value="淡黄苔(微黄苔)">淡黄苔(微黄苔)</label>
                                                <label><input type="radio" name="mossColor " value="焦黄苔(老黄苔)">焦黄苔(老黄苔)</label>
                                                <label><input type="radio" name="mossColor " value="黄腻苔">黄腻苔</label>
                                                <label><input type="radio" name="mossColor " value="灰黑苔">灰黑苔</label>
                                            </td>
                                        </tr>
                                        <tr>
                                            <td class="tongue-name bg-default">脉象</td>
                                            <td colspan="3">
                                                <label><input type="radio" name="pulseCondition " value="浮脉">浮脉</label>
                                                <label><input type="radio" name="pulseCondition" value="沉脉">沉脉</label>
                                                <label><input type="radio" name="pulseCondition" value="迟脉">迟脉</label>
                                                <label><input type="radio" name="pulseCondition" value="滑脉">滑脉</label>
                                                <label><input type="radio" name="pulseCondition" value="涩脉">涩脉</label>
                                                <label><input type="radio" name="pulseCondition" value="数脉">数脉</label>
                                                <label><input type="radio" name="pulseCondition" value="虚脉">虚脉</label>
                                                <label><input type="radio" name="pulseCondition" value="实脉">实脉</label>
                                                <label><input type="radio" name="pulseCondition" value="长脉">长脉</label>
                                                <label><input type="radio" name="pulseCondition" value="断脉">断脉</label>
                                                <label><input type="radio" name="pulseCondition" value="短脉">短脉</label>
                                                <label><input type="radio" name="pulseCondition" value="洪脉">洪脉</label>
                                                <label><input type="radio" name="pulseCondition" value="微脉">微脉</label>
                                                <label><input type="radio" name="pulseCondition" value="紧脉">紧脉</label>
                                                <label><input type="radio" name="pulseCondition" value="缓脉">缓脉</label>
                                                <label><input type="radio" name="pulseCondition" value="牢脉">牢脉</label>
                                                <label><input type="radio" name="pulseCondition" value="弦脉">弦脉</label>
                                                <label><input type="radio" name="pulseCondition" value="革脉">革脉</label>
                                                <label><input type="radio" name="pulseCondition" value="芤脉">芤脉</label>
                                                <label><input type="radio" name="pulseCondition" value="濡脉">濡脉</label>
                                                <label><input type="radio" name="pulseCondition" value="细脉">细脉</label>
                                                <label><input type="radio" name="pulseCondition" value="动脉">动脉</label>
                                                <label><input type="radio" name="pulseCondition" value="弱脉">弱脉</label>
                                                <label><input type="radio" name="pulseCondition" value="散脉">散脉</label>
                                                <label><input type="radio" name="pulseCondition" value="伏脉">伏脉</label>
                                                <label><input type="radio" name="pulseCondition" value="促脉">促脉</label>
                                                <label><input type="radio" name="pulseCondition" value="结脉">结脉</label>
                                                <label><input type="radio" name="pulseCondition" value="代脉">代脉</label>
                                                <label><input type="radio" name="pulseCondition" value="平脉">平脉</label>
                                            </td>
                                        </tr>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                        </div>
                        <!--中医部分 end-->

                        <div class="tgjc-baseMessage tgjc-border-bottom">
                            <div class="row">
                                <div class="col-xs-4">
                                    <span class="input-title">身高</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="请填写身高" name="height" class="form-control input-content-left">
                                        <span class="input-content-right">CM</span>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">体重</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="请填写体重" name="weight" class="form-control input-content-left">
                                        <span class="input-content-right">KG</span>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">BMI</span>
                                    <div class="input-content">
                                        <input type="number" readonly name="bmi" class="form-control input-content-left">
                                    </div>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-4">
                                    <span class="input-title">血压</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="高压" name="highesthypertension" class="form-control input-content-050">
                                        <span class="input-content-center">/</span>
                                        <input type="number" placeholder="低压" name="lowesthypertension" class="form-control input-content-050 input-contentR">
                                        <span class="input-content-right">mmHg</span>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">脉搏</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="请填写脉搏" name="heartrate" class="form-control input-content-left">
                                        <span class="input-content-right">次/分</span>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">腰围</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="请填写腰围" name="waist" class="form-control input-content-left">
                                        <span class="input-content-right">CM</span>
                                    </div>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-4">
                                    <span class="input-title">甲状腺</span>
                                    <div class="input-content">
                                        <select class="form-control m-b input-content-selsect" name="thyroid">
                                            <option value="0">未触及</option>
                                            <option value="1">大Ⅰ度</option>
                                            <option value="2">大Ⅱ度</option>
                                            <option value="3">大Ⅲ度</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">双下肢水肿</span>
                                    <div class="input-content">
                                        <select class="form-control m-b input-content-selsect" name="islimbedema">
                                            <option value="无">无</option>
                                            <option value="有">有</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">皮肤破溃</span>
                                    <div class="input-content">
                                        <select class="form-control m-b input-content-selsect" name="isskinulceration">
                                            <option value="无">无</option>
                                            <option value="有">有</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="row margin-top-20">
                            <div class="col-xs-12">
                                <table class="table-bordered text-center tgjc-table">
                                    <tbody>
                                    <tr>
                                        <td class="tgjcTable-title">锁骨上脂肪垫</td>
                                        <td>
                                            <label><input name="fatpad" value="" type="radio" checked>不详</label>
                                            <label><input name="fatpad" value="+" type="radio">+</label>
                                            <label><input name="fatpad" value="-" type="radio">-</label>
                                        </td>
                                        <td class="tgjcTable-title">水牛背</td>
                                        <td>
                                            <label><input name="buffaloback" value="" type="radio" checked>不详</label>
                                            <label><input name="buffaloback" value="+" type="radio">+</label>
                                            <label><input name="buffaloback" value="-" type="radio">-</label>
                                        </td>
                                        <td class="tgjcTable-title">颈部黑棘皮症</td>
                                        <td>
                                            <label><input name="isblackspine" value="" type="radio" checked>不详</label>
                                            <label><input name="isblackspine" value="+" type="radio">+</label>
                                            <label><input name="isblackspine" value="-" type="radio">-</label>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td class="tgjcTable-title">瘀斑</td>
                                        <td>
                                            <label><input name="ecchymosis" value="" type="radio" checked>不详</label>
                                            <label><input name="ecchymosis" value="+" type="radio">+</label>
                                            <label><input name="ecchymosis" value="-" type="radio">-</label>
                                        </td>
                                        <td class="tgjcTable-title">腹部紫纹</td>
                                        <td>
                                            <label><input name="abdominal" value="" type="radio" checked>不详</label>
                                            <label><input name="abdominal" value="+" type="radio">+</label>
                                            <label><input name="abdominal" value="-" type="radio">-</label>
                                        </td>
                                        <td class="tgjcTable-title">踝反射</td>
                                        <td>
                                            <label><input name="anklereflex" value="0" type="radio" checked>正常</label>
                                            <label><input name="anklereflex" value="1" type="radio">减弱或消失</label>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td class="tgjcTable-title">大脚趾针刺痛觉</td>
                                        <td>
                                            <label><input name="bigtoe1" value="0" type="radio" checked>正常</label>
                                            <label><input name="bigtoe1" value="1" type="radio">减弱或消失</label>
                                        </td>
                                        <td class="tgjcTable-title">大脚趾音叉振动觉</td>
                                        <td>
                                            <label><input name="bigtoe2" value="0" type="radio" checked>正常</label>
                                            <label><input name="bigtoe2" value="1" type="radio">减弱或消失</label>
                                        </td>
                                        <td class="tgjcTable-title">大脚趾10g尼龙丝触觉</td>
                                        <td>
                                            <label><input name="bigtoe3" value="0" type="radio" checked>正常</label>
                                            <label><input name="bigtoe3" value="1" type="radio">减弱或消失</label>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--备注-->
                        <div class="row margin-top-15">
                            <div class="col-xs-12 weight-change">
                                <span class="weight-title">备注信息</span>
                                <textarea name="" rows="10"></textarea>
                            </div>
                        </div>
                        <!--保存按钮-->
                        <div class="row margin-top-20">
                            <div class="col-xs-6 text-right">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存</button>
                            </div>
                            <div class="col-xs-6">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存并下一步</button>
                            </div>
                        </div>
                    </div>
                    <!--辅助检查-->
                    <div class="tab-pane" id="fuzhujiancha">
                        <div class="row">
                            <div class="col-xs-12">
                                <table class="table-bordered text-center auxiliaryCheck-table">
                                    <thead>
                                    <tr>
                                        <th>检查项</th>
                                        <th>测量日期</th>
                                        <th>检查地点</th>
                                        <th>是否打印</th>
                                    </tr>
                                    </thead>
                                    <tbody class="parent-tbody">
                                    <!--血糖项目 开始-->
                                    <tr>
                                        <td class="check-name">血糖</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xt_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xt_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xt_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xt_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">葡萄糖【0小时】</td>
                                                    <td class="width-080">Glu0</td>
                                                    <td class="width-080">
                                                        <input name="xt_glu0_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">
                                                        <select class="form-control m-b margin-bottom-0" name="unitfuzhukongfu">
                                                            <option value="mmol/L">mmol/L</option>
                                                            <option value="mg/dL">mg/dL</option>
                                                        </select>
                                                    </td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.9-6.1</td>
                                                    <td>
                                                        <input name="xt_glu0_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xt_glu0_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xt_glu0_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">葡萄糖【餐后2小时】</td>
                                                    <td class="width-080">Glu2</td>
                                                    <td class="width-080">
                                                        <input name="xt_glu2_result" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td class="width-080">
                                                        <select class="form-control m-b margin-bottom-0" name="unitfuzhucanhou">
                                                            <option value="mmol/L">mmol/L</option>
                                                            <option value="mg/dL">mg/dL</option>
                                                        </select>
                                                    </td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.9-7.8</td>
                                                    <td>
                                                        <input name="xt_glu2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xt_glu2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xt_glu2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血糖项目 结束-->
                                    <!--胰岛素项目 开始-->
                                    <tr>
                                        <td class="check-name">胰岛素</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="yds_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="yds_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="yds_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="yds_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">胰岛素【0】</td>
                                                    <td class="width-080">INS[0]</td>
                                                    <td class="width-080">
                                                        <input name="yds_ins0_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">uIU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">5.2-17.2</td>
                                                    <td>
                                                        <input name="yds_ins0_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yds_ins0_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yds_ins0_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">胰岛素【120】</td>
                                                    <td class="width-080">INS[120]</td>
                                                    <td class="width-080">
                                                        <input name="yds_ins120_result" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td class="width-080">uIU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="yds_ins120_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yds_ins120_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yds_ins120_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--胰岛素项目 结束-->
                                    <!--C肽项目 开始-->
                                    <tr>
                                        <td class="check-name">C肽</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ct_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ct_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ct_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ct_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">C肽【0】</td>
                                                    <td class="width-080">C-P[0]</td>
                                                    <td class="width-080">
                                                        <input name="ct_cp0_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.8-4.2</td>
                                                    <td>
                                                        <input name="ct_cp0_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ct_cp0_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ct_cp0_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">C肽【120】</td>
                                                    <td class="width-080">C-P[120]</td>
                                                    <td class="width-080">
                                                        <input name="ct_cp120_result" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td class="width-080">uIU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ct_cp120_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ct_cp120_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ct_cp120_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--C肽项目 结束-->
                                    <!--OGTT项目开始-->

                                    <tr>
                                        <td class="check-name">OGTT</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ogtt_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ogtt_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ogtt_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ogtt_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>0h</td>
                                                    <td>0.5h</td>
                                                    <td>1h</td>
                                                    <td>2h</td>
                                                    <td>3h</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">葡萄糖</td>
                                                    <td class="width-080">Glu(mmol/l)</td>
                                                    <td>
                                                        <input name="ogtt_glu_1" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_glu_2" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_glu_3" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_glu_4" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_glu_5" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">胰岛素</td>
                                                    <td class="width-080">Ins(uIU/ml)</td>
                                                    <td>
                                                        <input name="ogtt_ins_1" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_ins_2" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_ins_3" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_ins_4" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_ins_5" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血浆C肽</td>
                                                    <td class="width-080">C-P(ng/ml)</td>
                                                    <td>
                                                        <input name="ogtt_cp_1" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_cp_2" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_cp_3" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_cp_4" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ogtt_cp_5" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--OGTT项目结束-->
                                    <!--糖化项目开始-->
                                    <tr>
                                        <td class="check-name">糖化</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="th_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="th_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="th_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="th_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">糖化血红蛋白值</td>
                                                    <td class="width-080">HbA1c</td>
                                                    <td class="width-080">
                                                        <input name="th_hba1c_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080">H</td>
                                                    <td class="width-080">4.5-6.3</td>
                                                    <td>
                                                        <input name="th_hba1c_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="th_hba1c_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="th_hba1c_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">糖化白蛋白含量</td>
                                                    <td class="width-080">GA%</td>
                                                    <td class="width-080">
                                                        <input name="th_ga_result" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080">H</td>
                                                    <td class="width-080">10.8-17.1</td>
                                                    <td>
                                                        <input name="th_ga_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="th_ga_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="th_ga_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--糖化项目结束-->
                                    <!--1型糖尿病相关抗体项目开始-->
                                    <tr>
                                        <td class="check-name">1型糖尿病相关抗体</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xtnbxgkt_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xtnbxgkt_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xtnbxgkt_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xtnbxgkt_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">抗胰岛细胞抗体(IgG型)</td>
                                                    <td class="width-080">ICA</td>
                                                    <td class="width-080">
                                                        <label><input name="xtnbxgkt_ica_cb" value="-" type="radio" checked>-</label>
                                                        <label class="padding-left-15"><input name="xtnbxgkt_ica_cb" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">&lt;1:10</td>
                                                    <td>
                                                        <input name="xtnbxgkt_ica_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_ica_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_ica_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">抗谷氨酸脱羟酶抗体(IgG型)</td>
                                                    <td class="width-080">GAD</td>
                                                    <td class="width-080">
                                                        <label><input name="xtnbxgkt_gad_cb" value="-" type="radio" checked>-</label>
                                                        <label class="padding-left-15"><input name="xtnbxgkt_gad_cb" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">IU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">&lt;10</td>
                                                    <td>
                                                        <input name="xtnbxgkt_gad_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_gad_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_gad_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">抗酪氨酸磷酸酶抗体</td>
                                                    <td class="width-080">抗IA2</td>
                                                    <td class="width-080">
                                                        <label><input name="xtnbxgkt_kia2_cb" value="-" type="radio" checked>-</label>
                                                        <label class="padding-left-15"><input name="xtnbxgkt_kia2_cb" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">IU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">&lt;10</td>
                                                    <td>
                                                        <input name="xtnbxgkt_kia2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_kia2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_kia2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">胰岛素自身抗体</td>
                                                    <td class="width-080">IAA</td>
                                                    <td class="width-080">
                                                        <label><input name="xtnbxgkt_iaa_cb" value="-" type="radio" checked>-</label>
                                                        <label class="padding-left-15"><input name="xtnbxgkt_iaa_cb" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">IU/mL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">&lt;10</td>
                                                    <td>
                                                        <input name="xtnbxgkt_iaa_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_iaa_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xtnbxgkt_iaa_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--1型糖尿病相关抗体项目结束-->
                                    <!--ACR项目开始-->
                                    <tr>
                                        <td class="check-name">ACR</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="acr_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="acr_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="acr_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="acr_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">尿白蛋白肌酐比</td>
                                                    <td class="width-080">ACR</td>
                                                    <td class="width-080">
                                                        <input name="acr_acr_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/mgCr</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-30</td>
                                                    <td>
                                                        <input name="acr_acr_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="acr_acr_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="acr_acr_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--ACR项目结束-->
                                    <!--8h尿蛋白排泄率项目开始-->
                                    <tr>
                                        <td class="check-name">8h尿蛋白排泄率</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ndbpxl_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ndbpxl_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ndbpxl_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ndbpxl_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">8小时尿量</td>
                                                    <td class="width-080">8hU-V</td>
                                                    <td class="width-080">
                                                        <input name="ndbpxl_huv_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ndbpxl_huv_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_huv_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_huv_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿微量白蛋白</td>
                                                    <td class="width-080">UMA1B</td>
                                                    <td class="width-080">
                                                        <input name="ndbpxl_uma1b_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ndbpxl_uma1b_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_uma1b_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_uma1b_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿白蛋白排泄率</td>
                                                    <td class="width-080">UAE</td>
                                                    <td class="width-080">
                                                        <input name="ndbpxl_uae_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μg/min</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.00-0.20</td>
                                                    <td>
                                                        <input name="ndbpxl_uae_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_uae_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ndbpxl_uae_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--8h尿蛋白排泄率项目结束-->
                                    <!--尿常规项目开始-->
                                    <tr>
                                        <td class="check-name">尿常规</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ncg_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ncg_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ncg_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ncg_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">比重</td>
                                                    <td class="width-080">SG</td>
                                                    <td class="width-080">
                                                        <input name="ncg_sg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">1.005-1.030</td>
                                                    <td>
                                                        <input name="ncg_sg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_sg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_sg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">酸碱度(PH)</td>
                                                    <td class="width-080">PH</td>
                                                    <td class="width-080">
                                                        <input name="ncg_ph_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">5.0-8.0</td>
                                                    <td>
                                                        <input name="ncg_ph_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ph_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ph_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">白细胞(中性粒细胞酯酶)</td>
                                                    <td class="width-080">WBC</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_wbc_result" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="uwbc" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">Cell/ul</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><15</td>
                                                    <td>
                                                        <input name="ncg_wbc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_wbc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_wbc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">蛋白(白蛋白)</td>
                                                    <td class="width-080">PRO</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_pro_result" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="upro" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ncg_pro_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_pro_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_pro_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">葡萄糖</td>
                                                    <td class="width-080">GLU</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_gul_result" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="ugul" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ncg_gul_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_gul_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_gul_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">酮体</td>
                                                    <td class="width-080">KET</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_ket_result" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="uket" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ncg_ket_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ket_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ket_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿胆原</td>
                                                    <td class="width-080">UBG</td>
                                                    <td class="width-080">
                                                        <input name="ncg_ubg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">umol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3-16</td>
                                                    <td>
                                                        <input name="ncg_ubg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ubg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_ubg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">胆红素</td>
                                                    <td class="width-080">BIL</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_bil_result" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="ubil" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">umol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ncg_bil_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_bil_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_bil_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">红细胞(潜血)</td>
                                                    <td class="width-080">BLD</td>
                                                    <td class="width-080">
                                                        <label><input name="ncg_bld_cb" value="-" type="radio" checked="">-</label>
                                                        <label class="padding-left-15"><input name="ncg_bld_cb" value="+" type="radio">+</label>
                                                    </td>
                                                    <td class="width-080">Cell/ul</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><25</td>
                                                    <td>
                                                        <input name="ncg_bld_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_bld_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ncg_bld_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿液颜色(LD)</td>
                                                    <td class="width-080">LD</td>
                                                    <td class="width-080">
                                                        <input name="ncg_ld_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td></td>
                                                    <td></td>
                                                    <td></td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--尿常规项目结束-->
                                    <!--生化全项项目开始-->
                                    <tr>
                                        <td class="check-name">生化全项</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="shqx_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="shqx_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="shqx_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="shqx_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">丙氨酸氨基转化酶</td>
                                                    <td class="width-080">ALT</td>
                                                    <td class="width-080">
                                                        <input name="shqx_alt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">7-40</td>
                                                    <td>
                                                        <input name="shqx_alt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总蛋白(TP)</td>
                                                    <td class="width-080">TP</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tp_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">60-85</td>
                                                    <td>
                                                        <input name="shqx_tp_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tp_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tp_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">白蛋白</td>
                                                    <td class="width-080">Alb</td>
                                                    <td class="width-080">
                                                        <input name="shqx_alb_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">35-52</td>
                                                    <td>
                                                        <input name="shqx_alb_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alb_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alb_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">白蛋白球蛋白比</td>
                                                    <td class="width-080">A/G</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ag_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">1.0-2.5</td>
                                                    <td>
                                                        <input name="shqx_ag_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ag_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ag_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总胆红素</td>
                                                    <td class="width-080">TBil</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tbil_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">5.1-22.2</td>
                                                    <td>
                                                        <input name="shqx_tbil_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tbil_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tbil_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">直接胆红素</td>
                                                    <td class="width-080">DBil</td>
                                                    <td class="width-080">
                                                        <input name="shqx_dbil_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-6.8</td>
                                                    <td>
                                                        <input name="shqx_dbil_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_dbil_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_dbil_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">谷氨酰转肽酶</td>
                                                    <td class="width-080">GGT</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ggt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">7-45</td>
                                                    <td>
                                                        <input name="shqx_ggt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ggt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ggt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">碱性磷酸酶(ALP)</td>
                                                    <td class="width-080">ALP</td>
                                                    <td class="width-080">
                                                        <input name="shqx_alp_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">50-135</td>
                                                    <td>
                                                        <input name="shqx_alp_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alp_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_alp_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">天门冬氨酸氨基转移酶(AST)</td>
                                                    <td class="width-080">AST</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ast_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">50-135</td>
                                                    <td>
                                                        <input name="shqx_ast_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ast_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ast_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总胆汁酸(TBA)</td>
                                                    <td class="width-080">TBA</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tba_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">&lt;10.0</td>
                                                    <td>
                                                        <input name="shqx_tba_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tba_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tba_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">乳酸脱氢酶(LD)</td>
                                                    <td class="width-080">LD</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ld_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-250</td>
                                                    <td>
                                                        <input name="shqx_ld_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ld_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ld_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">胆碱酯酶(ChE)</td>
                                                    <td class="width-080">ChE</td>
                                                    <td class="width-080">
                                                        <input name="shqx_che_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">KU/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">5.0-12.0</td>
                                                    <td>
                                                        <input name="shqx_che_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_che_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_che_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钾</td>
                                                    <td class="width-080">K</td>
                                                    <td class="width-080">
                                                        <input name="shqx_k_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.5-5.5</td>
                                                    <td>
                                                        <input name="shqx_k_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_k_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_k_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钠</td>
                                                    <td class="width-080">Na</td>
                                                    <td class="width-080">
                                                        <input name="shqx_na_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">135-145</td>
                                                    <td>
                                                        <input name="shqx_na_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_na_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_na_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">氯</td>
                                                    <td class="width-080">Cl</td>
                                                    <td class="width-080">
                                                        <input name="shqx_cl_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">96-111</td>
                                                    <td>
                                                        <input name="shqx_cl_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_cl_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_cl_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总二氧化碳</td>
                                                    <td class="width-080">TCO2</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tco2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">20.0-34.0</td>
                                                    <td>
                                                        <input name="shqx_tco2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tco2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tco2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钙</td>
                                                    <td class="width-080">Ca</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ca_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.13-2.70</td>
                                                    <td>
                                                        <input name="shqx_tco2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tco2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tco2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">肌酐(酶法)</td>
                                                    <td class="width-080">Cr(E)</td>
                                                    <td class="width-080">
                                                        <input name="shqx_cre_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">45-84</td>
                                                    <td>
                                                        <input name="shqx_cre_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_cre_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_cre_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿素</td>
                                                    <td class="width-080">Urea</td>
                                                    <td class="width-080">
                                                        <input name="shqx_urea_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.78-7.14</td>
                                                    <td>
                                                        <input name="shqx_rea_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_rea_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_rea_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">葡萄糖</td>
                                                    <td class="width-080">Glu</td>
                                                    <td class="width-080">
                                                        <input name="shqx_glu_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.9-6.1</td>
                                                    <td>
                                                        <input name="shqx_glu_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_glu_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_glu_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿酸</td>
                                                    <td class="width-080">UA</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ua_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">umol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">150-357</td>
                                                    <td>
                                                        <input name="shqx_ua_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ua_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ua_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">无机磷</td>
                                                    <td class="width-080">P</td>
                                                    <td class="width-080">
                                                        <input name="shqx_p_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.81-1.45</td>
                                                    <td>
                                                        <input name="shqx_p_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_p_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_p_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总胆固醇</td>
                                                    <td class="width-080">TC</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.85-5.75</td>
                                                    <td>
                                                        <input name="shqx_tc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">甘油三脂</td>
                                                    <td class="width-080">TG</td>
                                                    <td class="width-080">
                                                        <input name="shqx_tg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.45-1.75</td>
                                                    <td>
                                                        <input name="shqx_tg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_tg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">高密度脂蛋白胆固醇</td>
                                                    <td class="width-080">HDL-C</td>
                                                    <td class="width-080">
                                                        <input name="shqx_hdlc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.93-1.81</td>
                                                    <td>
                                                        <input name="shqx_hdlc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_hdlc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_hdlc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">低密度脂蛋白胆固醇</td>
                                                    <td class="width-080">LDL-C</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ldlc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">正常人群应&lt;3.37，<br/>高危人群应&lt;2.59，<br/>极高危人群应&lt;2.07</td>
                                                    <td>
                                                        <input name="shqx_ldlc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ldlc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ldlc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">载脂蛋白A1</td>
                                                    <td class="width-080">ApoA1</td>
                                                    <td class="width-080">
                                                        <input name="shqx_apoa1_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">1.05-2.05</td>
                                                    <td>
                                                        <input name="shqx_apoa1_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_apoa1_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_apoa1_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">载脂蛋白B</td>
                                                    <td class="width-080">ApoB</td>
                                                    <td class="width-080">
                                                        <input name="shqx_apob_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.55-1.3</td>
                                                    <td>
                                                        <input name="shqx_apob_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_apob_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_apob_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">脂蛋白(a)</td>
                                                    <td class="width-080">Lp(a)</td>
                                                    <td class="width-080">
                                                        <input name="shqx_lpa_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-300</td>
                                                    <td>
                                                        <input name="shqx_lpa_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_lpa_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_lpa_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">超敏C反应蛋白</td>
                                                    <td class="width-080">hsCRP</td>
                                                    <td class="width-080">
                                                        <input name="shqx_hscrp_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-3.00</td>
                                                    <td>
                                                        <input name="shqx_hscrp_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_hscrp_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_hscrp_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">游离脂肪酸</td>
                                                    <td class="width-080">FFA</td>
                                                    <td class="width-080">
                                                        <input name="shqx_ffa_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">umol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">129-769</td>
                                                    <td>
                                                        <input name="shqx_ffa_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ffa_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_ffa_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">前白蛋白</td>
                                                    <td class="width-080">PA</td>
                                                    <td class="width-080">
                                                        <input name="shqx_pa_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">200-400</td>
                                                    <td>
                                                        <input name="shqx_pa_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_pa_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="shqx_pa_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--生化全项项目结束-->
                                    <!--肝功项目开始-->
                                    <tr>
                                        <td class="check-name">肝功</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="gg_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="gg_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="gg_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="gg_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">丙氨酸氨基转化酶</td>
                                                    <td class="width-080">ALT</td>
                                                    <td class="width-080">
                                                        <input name="gg_alt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">7-40</td>
                                                    <td>
                                                        <input name="gg_alt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">白蛋白</td>
                                                    <td class="width-080">Alb</td>
                                                    <td class="width-080">
                                                        <input name="gg_alb_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">60-85</td>
                                                    <td>
                                                        <input name="gg_alb_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alb_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alb_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总胆红素</td>
                                                    <td class="width-080">TBil</td>
                                                    <td class="width-080">
                                                        <input name="gg_tbil_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">5.1-22.2</td>
                                                    <td>
                                                        <input name="gg_tbil_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_tbil_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_tbil_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">直接胆红素</td>
                                                    <td class="width-080">DBil</td>
                                                    <td class="width-080">
                                                        <input name="gg_dbil_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-6.8</td>
                                                    <td>
                                                        <input name="gg_dbil_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_dbil_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_dbil_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">碱性磷酸酶</td>
                                                    <td class="width-080">ALP</td>
                                                    <td class="width-080">
                                                        <input name="gg_alp_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">50-135</td>
                                                    <td>
                                                        <input name="gg_alp_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alp_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_alp_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">天门冬氨酸氨基转移酶</td>
                                                    <td class="width-080">AST</td>
                                                    <td class="width-080">
                                                        <input name="gg_ast_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-6.8</td>
                                                    <td>
                                                        <input name="gg_ast_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_ast_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_ast_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">乳酸脱氢酶(LD)</td>
                                                    <td class="width-080">LD</td>
                                                    <td class="width-080">
                                                        <input name="gg_ld_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-250</td>
                                                    <td>
                                                        <input name="gg_ld_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_ld_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gg_ld_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--肝功结束-->

                                    <!--肾全项目  开始-->
                                    <tr>
                                        <td class="check-name">肾全</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="sq_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="sq_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="sq_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="kidneyallTestPrint">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">钾</td>
                                                    <td class="width-080">K</td>
                                                    <td class="width-080">
                                                        <input name="sq_k_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L	</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.5-5.5</td>
                                                    <td>
                                                        <input name="sq_k_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_k_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_k_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钠</td>
                                                    <td class="width-080">Na</td>
                                                    <td class="width-080">
                                                        <input name="sq_na_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">135-145</td>
                                                    <td>
                                                        <input name="sq_na_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_na_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_na_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">氯</td>
                                                    <td class="width-080">Cl</td>
                                                    <td class="width-080">
                                                        <input name="sq_cl_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">96-111</td>
                                                    <td>
                                                        <input name="sq_cl_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_cl_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_cl_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钙</td>
                                                    <td class="width-080">Ca</td>
                                                    <td class="width-080">
                                                        <input name="sq_ca_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.13-2.70</td>
                                                    <td>
                                                        <input name="sq_ca_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_ca_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="sq_ca_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">肌酐（酶法）</td>
                                                    <td class="width-080">Cr(E)</td>
                                                    <td class="width-080">
                                                        <input name="jg_cre_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">μmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">45-84</td>
                                                    <td>
                                                        <input name="jg_cre_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg_cre_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg_cre_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿素</td>
                                                    <td class="width-080">Urea</td>
                                                    <td class="width-080">
                                                        <input name="ns_urea_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.78-7.14</td>
                                                    <td>
                                                        <input name="ns_urea_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ns_urea_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ns_urea_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">葡萄糖</td>
                                                    <td class="width-080">Glu</td>
                                                    <td class="width-080">
                                                        <input name="ptt_glu_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.9-6.1</td>
                                                    <td>
                                                        <input name="ptt_glu_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ptt_glu_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ptt_glu_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿酸</td>
                                                    <td class="width-080">UA</td>
                                                    <td class="width-080">
                                                        <input name="ns_ua_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">umol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">150-357</td>
                                                    <td>
                                                        <input name="ns_ua_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ns_ua_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ns_ua_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">无机磷</td>
                                                    <td class="width-080">P</td>
                                                    <td class="width-080">
                                                        <input name="wjl_p_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.81-1.45</td>
                                                    <td>
                                                        <input name="wjl_p_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="wjl_p_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="wjl_p_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">估测肾小球滤过率</td>
                                                    <td class="width-080">eGFR</td>
                                                    <td class="width-080">
                                                        <input name="gcsxqlgl_egfr_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/d</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">80-120</td>
                                                    <td>
                                                        <input name="gcsxqlgl_egfr_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gcsxqlgl_egfr_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="gcsxqlgl_egfr_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--肾全项目  结束-->


                                    <!--电解质项目  开始-->
                                    <tr>
                                        <td class="check-name">电解质</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="djz_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="djz_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="djz_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="djz_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">钾</td>
                                                    <td class="width-080">K</td>
                                                    <td class="width-080">
                                                        <input name="djz_k_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.5-5.5</td>
                                                    <td>
                                                        <input name="djz_k_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_k_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_k_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                <tr>
                                                    <td class="son-name">钠</td>
                                                    <td class="width-080">Na</td>
                                                    <td class="width-080">
                                                        <input name="djz_na_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">135-145</td>
                                                    <td>
                                                        <input name="djz_na_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_na_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_na_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                <tr>
                                                    <td class="son-name">氯</td>
                                                    <td class="width-080">Cl</td>
                                                    <td class="width-080">
                                                        <input name="djz_cl_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">96-111</td>
                                                    <td>
                                                        <input name="djz_cl_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_cl_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_cl_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">总二氧化碳</td>
                                                    <td class="width-080">TCO2</td>
                                                    <td class="width-080">
                                                        <input name="djz_tco2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">20.0-34.0</td>
                                                    <td>
                                                        <input name="djz_tco2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_tco2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_tco2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">钙</td>
                                                    <td class="width-080">Ca</td>
                                                    <td class="width-080">
                                                        <input name="djz_ca_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.13-2.70</td>
                                                    <td>
                                                        <input name="djz_ca_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_ca_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="djz_ca_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--电解质项目  结束-->


                                    <!--血脂四项  开始-->
                                    <tr>
                                        <td class="check-name">血脂四项</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xzsx_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xzsx_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xzsx_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xzsx_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">总胆固醇</td>
                                                    <td class="width-080">TC</td>
                                                    <td class="width-080">
                                                        <input name="xzsx_tc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.85-5.70</td>
                                                    <td>
                                                        <input name="xzsx_tc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">甘油三脂</td>
                                                    <td class="width-080">TG</td>
                                                    <td class="width-080">
                                                        <input name="xzsx_tg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.45-1.75</td>
                                                    <td>
                                                        <input name="xzsx_tg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">高密度脂蛋白胆固醇</td>
                                                    <td class="width-080">HDL-C</td>
                                                    <td class="width-080">
                                                        <input name="xzsx_hdlc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.93-1.81</td>
                                                    <td>
                                                        <input name="xzsx_hdlc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_hdlc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_hdlc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">低密度脂蛋白胆固醇</td>
                                                    <td class="width-080">LDL-C</td>
                                                    <td class="width-080">
                                                        <input name="xzsx_tc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">正常人群应<3.37，</br>
                                                        高危人群应<2.59，</br>
                                                        极高危人群应<2.07</td>
                                                    <td>
                                                        <input name="xzsx_tc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzsx_tc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血脂四项项目  结束-->


                                    <!-- 胰功项目  开始-->
                                    <tr>
                                        <td class="check-name">胰功</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="yg_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="yg_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="yg_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="yg_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">淀粉酶</td>
                                                    <td class="width-080">AMY</td>
                                                    <td class="width-080">
                                                        <input name="yg_amy_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">25-115</td>
                                                    <td>
                                                        <input name="yg_amy_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yg_amy_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yg_amy_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">脂肪酶</td>
                                                    <td class="width-080">LIP</td>
                                                    <td class="width-080">
                                                        <input name="yg_lip_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">U/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">73-393</td>
                                                    <td>
                                                        <input name="yg_lip_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yg_lip_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="yg_lip_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--胰功项目  结束-->



                                    <!--甲功1项目  开始-->
                                    <tr>
                                        <td class="check-name">肝功</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="jg1_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="jg1_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="jg1_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="jg1_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">游离三碘甲状腺原氨酸</td>
                                                    <td class="width-080">FT3</td>
                                                    <td class="width-080">
                                                        <input name="jg1_ft3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">1.80-4.10</td>
                                                    <td>
                                                        <input name="jg1_ft3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_ft3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_ft3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">游离甲状腺素</td>
                                                    <td class="width-080">FT4</td>
                                                    <td class="width-080">
                                                        <input name="jg1_ft4_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.81-1.89</td>
                                                    <td>
                                                        <input name="jg1_ft4_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_ft4_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_ft4_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">促甲状腺素</td>
                                                    <td class="width-080">TSH3</td>
                                                    <td class="width-080">
                                                        <input name="jg1_tsh3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.38-4.34</td>
                                                    <td>
                                                        <input name="jg1_tsh3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_tsh3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg1_tsh3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--甲功1项目  结束-->



                                    <!--甲功2项目  开始-->
                                    <tr>
                                        <td class="check-name">甲功2</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="jg2_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="jg2_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="jg2_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="jg2_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">游离三碘甲状腺原氨酸</td>
                                                    <td class="width-080">FT3</td>
                                                    <td class="width-080">
                                                        <input name="jg2_ft3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">1.80-4.10</td>
                                                    <td>
                                                        <input name="jg2_ft3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_ft3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_ft3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">游离甲状腺素</td>
                                                    <td class="width-080">FT4</td>
                                                    <td class="width-080">
                                                        <input name="jg2_ft4_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.81-1.89</td>
                                                    <td>
                                                        <input name="jg2_ft4_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_ft4_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_ft4_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">三碘甲状腺原氨酸</td>
                                                    <td class="width-080">T3</td>
                                                    <td class="width-080">
                                                        <input name="jg2_t3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.66-1.92</td>
                                                    <td>
                                                        <input name="jg2_t3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_t3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_t3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">甲状腺素</td>
                                                    <td class="width-080">DBil</td>
                                                    <td class="width-080">
                                                        <input name="jg2_t4_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/dL</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">4.30-12.50</td>
                                                    <td>
                                                        <input name="jg2_t4_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_t4_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_t4_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">促甲状腺素</td>
                                                    <td class="width-080">TSH3</td>
                                                    <td class="width-080">
                                                        <input name="jg2_fsh3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.38-4.34</td>
                                                    <td>
                                                        <input name="jg2_fsh3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_fsh3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jg2_fsh3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--甲功2项目  结束-->


                                    <!--甲状腺相关抗体项目  开始-->
                                    <tr>
                                        <td class="check-name">甲状腺相关抗体</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="jzxxgkt_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="jzxxgkt_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="jzxxgkt_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="jzxxgkt_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">甲状腺球蛋白抗体</td>
                                                    <td class="width-080">A-Tg</td>
                                                    <td class="width-080">
                                                        <input name="jzxxgkt_atg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">IU/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><115</td>
                                                    <td>
                                                        <input name="jzxxgkt_atg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jzxxgkt_atg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jzxxgkt_atg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">甲状腺过氧化物酶抗体</td>
                                                    <td class="width-080">A-TPO</td>
                                                    <td class="width-080">
                                                        <input name="jzxxgkt_atpo_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">IU/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><34</td>
                                                    <td>
                                                        <input name="jzxxgkt_atpo_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jzxxgkt_atpo_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jzxxgkt_atpo_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--甲状腺相关抗体项目  结束-->


                                    <!--血浆ACTH项目  开始-->
                                    <tr>
                                        <td class="check-name">血浆ACTH</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xjacth_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xjacth_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xjacth_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xjacth_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">促肾上腺皮质激素(0AM)</td>
                                                    <td class="width-080">ACTH(0AM)</td>
                                                    <td class="width-080">
                                                        <input name="xjacth_acth0am_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0-46</td>
                                                    <td>
                                                        <input name="xjacth_acth0am_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth0am_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth0am_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">促肾上腺皮质激素(8AM)</td>
                                                    <td class="width-080">ACTH(8AM)</td>
                                                    <td class="width-080">
                                                        <input name="xjacth_acth8am_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xjacth_acth8am_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth8am_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth8am_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">促肾上腺皮质激素(4PM)</td>
                                                    <td class="width-080">ACTH(4PM)</td>
                                                    <td class="width-080">
                                                        <input name="xjacth_acth4pm_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xjacth_acth4pm_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth4pm_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xjacth_acth4pm_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血浆ACTH项目  结束-->


                                    <!--血总皮质醇项目  开始-->
                                    <tr>
                                        <td class="check-name">血总皮质醇</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xzpzc_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xzpzc_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xzpzc_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xzpzc_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">血总皮质醇(0AM)</td>
                                                    <td class="width-080">F(0AM)</td>
                                                    <td class="width-080">
                                                        <input name="xzpzc_f0am_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">4.0-22.3</td>
                                                    <td>
                                                        <input name="xzpzc_f0am_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f0am_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f0am_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血总皮质醇(8AM)</td>
                                                    <td class="width-080">F(8AM)</td>
                                                    <td class="width-080">
                                                        <input name="xzpzc_f0am_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xzpzc_f8am_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f8am_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f8am_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血总皮质醇(4PM)</td>
                                                    <td class="width-080">F(4PM)</td>
                                                    <td class="width-080">
                                                        <input name="xzpzc_f4pm_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xzpzc_f4pm_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f4pm_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_f4pm_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血总皮质醇(过夜小剂量后)</td>
                                                    <td class="width-080">F(过夜小剂量后)</td>
                                                    <td class="width-080">
                                                        <input name="xzpzc_fgyxjlh_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/dl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xzpzc_fgyxjlh_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_fgyxjlh_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xzpzc_fgyxjlh_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血总皮质醇项目  结束-->


                                    <!--内分泌六项  开始-->
                                    <tr>
                                        <td class="check-name">内分泌六项</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="nfmlx_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="nfmlx_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="nfmlx_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="nfmlx_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">促黄体生成素</td>
                                                    <td class="width-080">LH</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_lh_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">IU/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">卵泡期：2.12-10.89；排卵期19.18-103.03；<br/>
                                                        黄体期1.20-12.86；绝经期10.87-58.64</td>
                                                    <td>
                                                        <input name="nfmlx_lh_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_lh_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_lh_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">促卵泡成熟激素</td>
                                                    <td class="width-080">FSH</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_fsh_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">IU/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">卵泡期：<10；排卵期4.54-30.34；<br/>
                                                        黄体期1.65-9.66；绝经期>40</td>
                                                    <td>
                                                        <input name="nfmlx_fsh_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_fsh_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_fsh_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">雌二醇</td>
                                                    <td class="width-080">E2</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_e2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ug/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">卵泡期：27-122；排卵期95-433；<br/>
                                                        黄体期49-291；绝经期<40</td>
                                                    <td>
                                                        <input name="nfmlx_e2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_e2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_e2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">孕酮</td>
                                                    <td class="width-080">P</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_p_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">卵泡期：0.38-2.28；排卵期0.93-2.23；<br/>
                                                        黄体期5.16-29.26；绝经期<0.78</td>
                                                    <td>
                                                        <input name="nfmlx_p_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_p_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_p_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">睾酮</td>
                                                    <td class="width-080">T</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_t_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.10-0.75</td>
                                                    <td>
                                                        <input name="nfmlx_t_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_t_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_t_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">泌乳素</td>
                                                    <td class="width-080">PRL</td>
                                                    <td class="width-080">
                                                        <input name="nfmlx_prl_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><30</td>
                                                    <td>
                                                        <input name="nfmlx_prl_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_prl_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nfmlx_prl_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--内分泌六项项目  结束-->

                                    <!--生长激素项目  开始-->
                                    <tr>
                                        <td class="check-name">生长激素</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="szjs_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="szjs_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="szjs_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="szjs_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">生长激素</td>
                                                    <td class="width-080">GH</td>
                                                    <td class="width-080">
                                                        <input name="szjs_gh_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"><2.0</td>
                                                    <td>
                                                        <input name="szjs_gh_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="szjs_gh_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="szjs_gh_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--生长激素项目  结束-->

                                    <!-- 胰岛素样生长因子项目  开始-->
                                    <tr>
                                        <td class="check-name">胰岛素样生长因子</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ydsyszyz_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ydsyszyz_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ydsyszyz_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ydsyszyz_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">类胰岛素生长因子1</td>
                                                    <td class="width-080">IGF1</td>
                                                    <td class="width-080">
                                                        <input name="ydsyszyz_igf1_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">69-200</td>
                                                    <td>
                                                        <input name="ydsyszyz_igf1_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ydsyszyz_igf1_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ydsyszyz_igf1_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--胰岛素样生长因子项目  结束-->

                                    <!--血常规项目  开始-->
                                    <tr>
                                        <td class="check-name">血常规</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xcg_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xcg_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xcg_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xcg_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">白细胞数目 WBC 10^9/L</td>
                                                    <td class="width-080">IGF1</td>
                                                    <td class="width-080">
                                                        <input name="xcg_igf1_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.50-9.50</td>
                                                    <td>
                                                        <input name="xcg_igf1_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_igf1_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_igf1_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">淋巴细胞百分比</td>
                                                    <td class="width-080">LY%</td>
                                                    <td class="width-080">
                                                        <input name="xcg_ly_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">20.0-40.0	</td>
                                                    <td>
                                                        <input name="xcg_ly_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ly_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ly_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">单核细胞百分比</td>
                                                    <td class="width-080">MONO%</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mono_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.0-8.0</td>
                                                    <td>
                                                        <input name="xcg_mono_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mono_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mono_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">中性粒细胞百分比</td>
                                                    <td class="width-080">NEUT%</td>
                                                    <td class="width-080">
                                                        <input name="xcg_neut_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">50.0-75.0</td>
                                                    <td>
                                                        <input name="xcg_neut_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_neut_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_neut_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">嗜酸性粒细胞百分比</td>
                                                    <td class="width-080">EOS%</td>
                                                    <td class="width-080">
                                                        <input name="cxg_eos_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.5-5.0</td>
                                                    <td>
                                                        <input name="cxg_eos_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="cxg_eos_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="cxg_eos_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">嗜碱性粒细胞百分比</td>
                                                    <td class="width-080">BASO%</td>
                                                    <td class="width-080">
                                                        <input name="xcg_baso_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-1.0</td>
                                                    <td>
                                                        <input name="xcg_baso_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_baso_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_baso_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">未染色大细胞百分比</td>
                                                    <td class="width-080">LUC%</td>
                                                    <td class="width-080">
                                                        <input name="xcg_luc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-4.0</td>
                                                    <td>
                                                        <input name="xcg_luc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_luc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_luc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">淋巴细胞绝对值</td>
                                                    <td class="width-080">LY#</td>
                                                    <td class="width-080">
                                                        <input name="xcg_ly2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.80-4.00</td>
                                                    <td>
                                                        <input name="xcg_ly2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ly2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ly2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">单核细胞绝对值</td>
                                                    <td class="width-080">MONO#</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mono2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.12-0.80</td>
                                                    <td>
                                                        <input name="xcg_mono2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mono2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mono2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">中性粒细胞绝对值</td>
                                                    <td class="width-080">NEUT#</td>
                                                    <td class="width-080">
                                                        <input name="xcg_neut2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">2.00-7.50</td>
                                                    <td>
                                                        <input name="xcg_neut2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_neut2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_neut2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">嗜酸性粒细胞绝对值</td>
                                                    <td class="width-080">EOS#</td>
                                                    <td class="width-080">
                                                        <input name="xcg_eos2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.02-0.50</td>
                                                    <td>
                                                        <input name="xcg_eos2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_eos2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_eos2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">嗜碱性粒细胞绝对值</td>
                                                    <td class="width-080">BASO#</td>
                                                    <td class="width-080">
                                                        <input name="xcg_baso2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.00-0.10</td>
                                                    <td>
                                                        <input name="xcg_baso2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_baso2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_baso2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">红细胞</td>
                                                    <td class="width-080">RBC</td>
                                                    <td class="width-080">
                                                        <input name="xcg_rbc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S12/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">3.50-5.00</td>
                                                    <td>
                                                        <input name="xcg_rbc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_rbc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_rbc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血红蛋白</td>
                                                    <td class="width-080">HGB</td>
                                                    <td class="width-080">
                                                        <input name="xcg_hgb_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">110-150</td>
                                                    <td>
                                                        <input name="xcg_hgb_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hgb_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hgb_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">红细胞压积</td>
                                                    <td class="width-080">HCT</td>
                                                    <td class="width-080">
                                                        <input name="xcg_hct_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xcg_hct_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hct_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hct_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">平均红细胞体积</td>
                                                    <td class="width-080">MCV</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mcv_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">fl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">82.0-97.0</td>
                                                    <td>
                                                        <input name="xcg_mcv_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mcv_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mcv_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">平均红细胞血红蛋白浓度</td>
                                                    <td class="width-080">MCHC</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mchc_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">320-360</td>
                                                    <td>
                                                        <input name="xcg_mchc_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mchc_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mchc_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">平均红细胞血红蛋白</td>
                                                    <td class="width-080">MCH</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mch_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">27.0-32.0</td>
                                                    <td>
                                                        <input name="xcg_mch_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mch_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mch_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">单个细胞血红蛋白含量</td>
                                                    <td class="width-080">CHCM</td>
                                                    <td class="width-080">
                                                        <input name="xcg_chcm_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">320-360</td>
                                                    <td>
                                                        <input name="xcg_chcm_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_chcm_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_chcm_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">单个细胞血红蛋白</td>
                                                    <td class="width-080">CH</td>
                                                    <td class="width-080">
                                                        <input name="xcg_ch_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">pg</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">27.0-32.0</td>
                                                    <td>
                                                        <input name="xcg_ch_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ch_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_ch_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">红细胞体积分布宽度</td>
                                                    <td class="width-080">RDW</td>
                                                    <td class="width-080">
                                                        <input name="xcg_rdw_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.0-15.0</td>
                                                    <td>
                                                        <input name="xcg_rdw_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_rdw_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_rdw_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血红蛋白分布宽度</td>
                                                    <td class="width-080">HDW</td>
                                                    <td class="width-080">
                                                        <input name="xcg_hdw_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">20.0-30.0</td>
                                                    <td>
                                                        <input name="xcg_hdw_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hdw_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_hdw_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血小板</td>
                                                    <td class="width-080">PLT</td>
                                                    <td class="width-080">
                                                        <input name="xcg_plt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">×10S9/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">100-350</td>
                                                    <td>
                                                        <input name="xcg_plt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_plt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_plt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血小板压积</td>
                                                    <td class="width-080">PCT</td>
                                                    <td class="width-080">
                                                        <input name="xcg_pct_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">0.11-0.28</td>
                                                    <td>
                                                        <input name="xcg_pct_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_pct_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_pct_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血小板压积分布宽度</td>
                                                    <td class="width-080">PDW</td>
                                                    <td class="width-080">
                                                        <input name="xcg_pdw_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">%</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">35.0-75.0</td>
                                                    <td>
                                                        <input name="xcg_pdw_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_pdw_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_pdw_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">平均血小板体积</td>
                                                    <td class="width-080">MPV</td>
                                                    <td class="width-080">
                                                        <input name="xcg_mpv_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">fl</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">7.0-13.0</td>
                                                    <td>
                                                        <input name="xcg_mpv_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mpv_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xcg_mpv_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血常规项目  结束-->

                                    <!--血气分析项目  开始-->
                                    <tr>
                                        <td class="check-name">血气分析</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="xqfx_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="xqfx_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="xqfx_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="xqfx_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">酸碱度值</td>
                                                    <td class="width-080">PH</td>
                                                    <td class="width-080">
                                                        <input name="xqfx_ph_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xqfx_ph_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_ph_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_ph_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">乳酸值</td>
                                                    <td class="width-080">Lac</td>
                                                    <td class="width-080">
                                                        <input name="xqfx_lac_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xqfx_lac_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_lac_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_lac_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">酸氢根值</td>
                                                    <td class="width-080">HCO3_</td>
                                                    <td class="width-080">
                                                        <input name="xqfx_hc03_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xqfx_hc03_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_hc03_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_hc03_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">氧分压值</td>
                                                    <td class="width-080">PO2</td>
                                                    <td class="width-080">
                                                        <input name="xqfx_po2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">kPa</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="xqfx_po2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_po2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_po2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">二氧化碳分压</td>
                                                    <td class="width-080">PC02</td>
                                                    <td class="width-080">
                                                        <input name="xqfx_pco2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">kPa</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">9.98~13.30kPa(75~100mmHq)</td>
                                                    <td>
                                                        <input name="xqfx_pco2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_pco2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="xqfx_pco2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--血气分析项目  结束-->

                                    <!--凝血2项目  开始-->
                                    <tr>
                                        <td class="check-name">凝血2</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="nx2_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="nx2_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="nx2_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="nx2_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">凝血酶原时间</td>
                                                    <td class="width-080">PT</td>
                                                    <td class="width-080">
                                                        <input name="nx2_pt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">s</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_pt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_pt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_pt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">凝血酶原活动度</td>
                                                    <td class="width-080">PT%</td>
                                                    <td class="width-080">
                                                        <input name="nx2_pt2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_pt2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_pt2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_pt2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">国际标准化比值</td>
                                                    <td class="width-080">INR</td>
                                                    <td class="width-080">
                                                        <input name="nx2_inr_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_inr_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_inr_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_inr_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">纤维蛋白原</td>
                                                    <td class="width-080">Fbg</td>
                                                    <td class="width-080">
                                                        <input name="nx2_fbg_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">g/L</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_fbg_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_fbg_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_fbg_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">活化部分凝血活酶时间</td>
                                                    <td class="width-080">APTT</td>
                                                    <td class="width-080">
                                                        <input name="nx2_aptt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">s</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_aptt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_aptt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_aptt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">活化部分凝血活酶时间比值</td>
                                                    <td class="width-080">APTT-R</td>
                                                    <td class="width-080">
                                                        <input name="nx2_apttr_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_apttr_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_apttr_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_apttr_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">凝血酶时间</td>
                                                    <td class="width-080">TT</td>
                                                    <td class="width-080">
                                                        <input name="nx2_tt_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">s</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_tt_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_tt_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_tt_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">血浆D-二聚体</td>
                                                    <td class="width-080">D-Dimer</td>
                                                    <td class="width-080">
                                                        <input name="nx2_ddimer_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080">mg/L FEU</td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="nx2_ddimer_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_ddimer_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="nx2_ddimer_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--凝血2项目  结束-->

                                    <!--地塞米松抑制试验项目  开始-->
                                    <tr>
                                        <td class="check-name">地塞米松抑制试验</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="dsmsyzsy_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="dsmsyzsy_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="dsmsyzsy_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="dsmsyzsy_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">联合大小DST实验24hUFC（对照日1）</td>
                                                    <td class="width-080">24hUFC(D1)</td>
                                                    <td class="width-080">
                                                        <input name="dsmsyzsy_24hufcd1_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd1_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd1_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd1_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">联合大小DST实验24hUFC（对照日2）</td>
                                                    <td class="width-080">24hUFC(D2)</td>
                                                    <td class="width-080">
                                                        <input name="dsmsyzsy_24hufcd2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">联合大小DST实验24hUFC（小量第2日）</td>
                                                    <td class="width-080">24hUFC(D4)</td>
                                                    <td class="width-080">
                                                        <input name="dsmsyzsy_24hufcd4_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd4_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd4_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd4_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">联合大小DST实验24hUFC（大量第2日）</td>
                                                    <td class="width-080">24hUFC(D6)</td>
                                                    <td class="width-080">
                                                        <input name="dsmsyzsy_24hufcd6_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd6_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd6_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="dsmsyzsy_24hufcd6_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--地塞米松抑制试验项目  结束-->


                                    <!-- 25羟维生素D3项目  开始-->
                                    <tr>
                                        <td class="check-name">25羟维生素D3</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="qwssd3_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="qwssd3_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="qwssd3_local_date" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="qwssd3_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">25羟维生素D2</td>
                                                    <td class="width-080">25OHO2</td>
                                                    <td class="width-080">
                                                        <input name="qwssd3_oho2_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="qwssd3_oho2_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_oho2_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_oho2_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">25羟维生素D</td>
                                                    <td class="width-080">T-25OHD</td>
                                                    <td class="width-080">
                                                        <input name="qwssd3_t25ohd_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">ng/ml</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="qwssd3_t25ohd_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_t25ohd_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_t25ohd_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">25羟维生素D3</td>
                                                    <td class="width-080">25OHD3</td>
                                                    <td class="width-080">
                                                        <input name="qwssd3_ohd3_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="qwssd3_ohd3_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_ohd3_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="qwssd3_ohd3_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--25羟维生素D3  结束-->
                                    <!--24h尿钙（U-Ca）+24h尿磷（U-P）  开始-->
                                    <tr>
                                        <td class="check-name">24h尿钙（U-Ca）+24h尿磷（U-P）</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="ngns_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="ngns_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="ngns_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="ngns_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">24小时尿量</td>
                                                    <td class="width-080">24hU-V</td>
                                                    <td class="width-080">
                                                        <input name="ngns_24huv_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">ml</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ngns_huv_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_huv_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_huv_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿钙</td>
                                                    <td class="width-080">U-Ca</td>
                                                    <td class="width-080">
                                                        <input name="ngns_uca_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ngns_uca_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_uca_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_uca_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">尿磷</td>
                                                    <td class="width-080">U-P</td>
                                                    <td class="width-080">
                                                        <input name="ngns_up_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">mmol/L</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ngns_up_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_up_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_up_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">24小时尿钙</td>
                                                    <td class="width-080">24hUCa</td>
                                                    <td class="width-080">
                                                        <input name="ngns_24huca_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">mmol/24h</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ngns_24huca_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_24huca_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_24huca_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>
                                                <tr>
                                                    <td class="son-name">24小时尿磷</td>
                                                    <td class="width-080">24hUP</td>
                                                    <td class="width-080">
                                                        <input name="ngns_24hup_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">mmol/24h</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="ngns_24hup_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_24hup_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="ngns_24hup_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--24h尿钙（U-Ca）+24h尿磷（U-P）项目  结束-->
                                    <!--β-胶原降解产物测定项目  开始-->
                                    <tr>
                                        <td class="check-name">β-胶原降解产物测定</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="jyjjcwcd_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td>
                                            <label><input name="jyjjcwcd_local_test" value="本" type="radio" checked>本院测</label>
                                            <label class="padding-left-15"><input name="jyjjcwcd_other_test" value="外" type="radio">外院测</label>
                                        </td>
                                        <td>
                                            <label><input type="checkbox" value="1" name="jyjjcwcd_print">打印</label>
                                        </td>
                                    </tr>
                                    <tr class="bg-default">
                                        <td colspan="4">
                                            <table class="table-bordered text-center sub-table">
                                                <thead>
                                                <tr>
                                                    <td>项目</td>
                                                    <td>缩写</td>
                                                    <td>结果</td>
                                                    <td>单位</td>
                                                    <td>异常提示</td>
                                                    <td>参考范围</td>
                                                    <td>药敏结果</td>
                                                    <td>危急提示</td>
                                                    <td>备注</td>
                                                </tr>
                                                </thead>
                                                <tbody>
                                                <tr>
                                                    <td class="son-name">β-胶原降解产物</td>
                                                    <td class="width-080">β-CTX</td>
                                                    <td class="width-080">
                                                        <input name="jyjjcwcd_ctx_result" class="form-control" type="text" placeholder="请输入..."/></td>
                                                    <td class="width-080"></td>
                                                    <td class="width-080">g</td>
                                                    <td class="width-080"></td>
                                                    <td>
                                                        <input name="jyjjcwcd_ctx_drugres" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jyjjcwcd_ctx_crisis" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                    <td>
                                                        <input name="jyjjcwcd_ctx_remark" class="form-control" type="text" placeholder="请输入..."/>
                                                    </td>
                                                </tr>

                                                </tbody>
                                            </table>
                                        </td>
                                    </tr>
                                    <!--β-胶原降解产物测定  结束-->
                                    <!-- 影像学检查  开始-->
                                    <tr>
                                        <td class="check-name"> 影像学检查</td>
                                        <td class="check-time">
                                            <input type="text" class="form-control" data-toggle="datepicker" name="yxxjc_test_date" placeholder="请输入检查日期">
                                        </td>
                                        <td></td>
                                        <td></td>
                                    </tr>
                                    <!-- 影像学检查  结束-->
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--备注-->
                        <div class="row margin-top-15">
                            <div class="col-xs-12 weight-change">
                                <span class="weight-title">备注信息</span>
                                <textarea name="" rows="10"></textarea>
                            </div>
                        </div>
                        <!--保存按钮-->
                        <div class="row margin-top-20">
                            <div class="col-xs-6 text-right">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存</button>
                            </div>
                            <div class="col-xs-6">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存并下一步</button>
                            </div>
                        </div>
                    </div>
                    <!--诊断-->
                    <div class="tab-pane" id="zhenduan">
                        <div class="row">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-primary btn-outline btn-lg" data-toggle="modal" data-target="#addDiagnosis">添加诊断</button>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center diagnosis-table">
                                    <thead>
                                    <tr>
                                        <th>病名</th>
                                        <th>ICD编码</th>
                                        <th>操作</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>高血压病</td>
                                        <td>E10.951</td>
                                        <td><button type="button" class="btn btn-outline btn-danger">删除</button></td>
                                    </tr>
                                    <tr>
                                        <td>高血压病</td>
                                        <td>E10.951</td>
                                        <td><button type="button" class="btn btn-outline btn-danger">删除</button></td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>

                        <!--中医部分 start-->
                        <div class="row margin-top-20">
                            <div class="col-xs-12 xbs-separated">
                                <span>中医诊断</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-5 input-box-one">
                                <span class="input-title-position">中医诊断分型</span>
                                <select class="form-control m-b input-content" name="tcmDiagnosis">
                                    <option value="1">阴虚燥热</option>
                                    <option value="2">气阴两虚</option>
                                    <option value="3">阴阳两虚</option>
                                    <option value="4">阴阳欲绝</option>
                                </select>
                            </div>
                            <div class="col-xs-7 zd-zyzd">
                                挟
                                <label><input type="checkbox" name="wind">&nbsp;风</label>
                                <label><input type="checkbox" name="cold">&nbsp;寒</label>
                                <label><input type="checkbox" name="summerheat">&nbsp;暑</label>
                                <label><input type="checkbox" name="wet">&nbsp;湿</label>
                                <label><input type="checkbox" name="dryness">&nbsp;燥</label>
                                <label><input type="checkbox" name="hot">&nbsp;热</label>
                                <label><input type="checkbox" name="silt">&nbsp;淤</label>
                            </div>
                        </div>
                        <!--中医部分 end-->

                        <!--备注-->
                        <div class="row margin-top-20">
                            <div class="col-xs-12 weight-change">
                                <span class="weight-title">备注信息</span>
                                <textarea name="" rows="10"></textarea>
                            </div>
                        </div>
                        <!--保存按钮-->
                        <div class="row margin-top-20">
                            <div class="col-xs-6 text-right">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存</button>
                            </div>
                            <div class="col-xs-6">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存并下一步</button>
                            </div>
                        </div>
                    </div>
                    <!--处理-->
                    <div class="tab-pane" id="chuli">
                        <div class="row">
                            <div class="col-xs-12 xbs-separated">
                                <span>设定患者控制目标</span>
                            </div>
                        </div>
                        <div class="cl-baseMessage">
                            <div class="row">
                                <div class="col-xs-12">
                                    <div class="row margin-top-15">
                                        <div class="col-xs-4">
                                            <span class="input-title">HbA1c</span>
                                            <div class="input-content">
                                                <select class="form-control m-b input-content-selsect" name="hba1c">
                                                    <option value="6.5" selected>6.5%</option>
                                                    <option value="7.0">7.0%</option>
                                                </select>
                                            </div>
                                        </div>
                                        <div class="col-xs-4">
                                            <span class="input-title">空腹血糖</span>
                                            <div class="input-content">
                                                <select class="form-control m-b input-content-selsect" name="fastingblood">
                                                    <option value="5~6" selected>5~6mmol/L</option>
                                                    <option value="5~7">5~7mmol/L</option>
                                                </select>
                                            </div>
                                        </div>
                                        <div class="col-xs-4">
                                            <span class="input-title">餐后2h血糖</span>
                                            <div class="input-content">
                                                <select class="form-control m-b input-content-selsect" name="meal2hblood">
                                                    <option value="6~8" selected>6~8mmol/L</option>
                                                    <option value="6~10">6~10mmol/L</option>
                                                </select>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="row margin-top-15">
                                <div class="col-xs-4">
                                    <span class="input-title">血压</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="高压" name="highesthypertension1" class="form-control input-content-050">
                                        <span class="input-content-center">/</span>
                                        <input type="number" placeholder="低压" name="lowesthypertension1" class="form-control input-content-050 input-contentR">
                                        <span class="input-content-right">mmHg</span>
                                    </div>
                                </div>
                                <div class="col-xs-4">
                                    <span class="input-title">血脂</span>
                                    <div class="input-content">
                                        <input type="number" placeholder="请填写脉搏" name="bloodfat" class="form-control input-content-left">
                                        <span class="input-content-right">mmol/L</span>
                                    </div>
                                </div>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>专科建议</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center cl-table1">
                                    <thead>
                                    <tr>
                                        <th>
                                            <input type="checkbox" name="allCheck">选择意见
                                        </th>
                                        <th>补充意见</th>
                                        <th>选择意见</th>
                                        <th>补充意见</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>
                                            <label><input name="isjieshi" type="checkbox"/>解释注意事项</label>
                                        </td>
                                        <td></td>
                                        <td>
                                            <label><input name="iscontroldiet" type="checkbox"/>合理控制饮食</label>
                                        </td>
                                        <td class="input-td">
                                            <input type="text" class="form-control" name="controldietsuggest" placeholder="请输入具体意见...">
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="isjieshi" type="checkbox"/>监测血糖并记录</label>
                                        </td>
                                        <td>
                                            <label><input name="monitorblood[]" type="checkbox" value="0"/>早餐前</label>
                                            <label class="margin-left-10"><input name="monitorblood[]" type="checkbox" value="2"/>午餐前</label>
                                            <label class="margin-left-10"><input name="monitorblood[]" type="checkbox" value="4"/>晚餐前</label>
                                            <br>
                                            <label><input name="monitorblood[]" type="checkbox" value="6"/>睡前</label>
                                            <label><input name="monitorblood[]" type="checkbox" value="1"/>早餐后2h</label>
                                            <label><input name="monitorblood[]" type="checkbox" value="3"/>午餐后2h</label>
                                            <br>
                                            <label><input name="monitorblood[]" type="checkbox" value="5"/>晚餐后2h</label>
                                            <label><input name="monitorblood[]" type="checkbox" value="7"/>凌晨</label>
                                        </td>
                                        <td>
                                            <label><input name="ishandian" type="checkbox"/>忌食含碘食物</label>
                                        </td>
                                        <td></td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="iscontroldiet" type="checkbox"/>规律运动</label>
                                        </td>
                                        <td class="input-td">
                                            <input type="text" class="form-control" name="regularexercisesuggest" placeholder="请输入具体意见...">
                                        </td>
                                        <td>
                                            <label><input name="isweightloss" type="checkbox"/>减重</label>
                                        </td>
                                        <td class="input-td">
                                            <input type="text" class="form-control" name="weightlosssuggest" placeholder="请输入具体意见...">
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="isgaodian" type="checkbox"/>忌食高碘食物</label>
                                        </td>
                                        <td></td>
                                        <td>
                                            <label><input name="istreatment" type="checkbox"/>治疗暂不变</label>
                                        </td>
                                        <td></td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="isregularmedication" type="checkbox"/>规律用药</label>
                                        </td>
                                        <td></td>
                                        <td>
                                            <label><input name="israndomdiagnosis" type="checkbox"/>随诊</label>
                                        </td>
                                        <td></td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="joinclass" type="checkbox"/>参加患者教育课程</label>
                                        </td>
                                        <td></td>
                                        <td>
                                            <label><input name="isothertreatment" type="checkbox"/>(其)余治疗不变</label>
                                        </td>
                                        <td></td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>检查方案</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center cl-table1">
                                    <thead>
                                    <tr>
                                        <th>
                                            <input type="checkbox" name="allCheckProject">检查项目
                                        </th>
                                        <th>检查周期</th>
                                        <th>检查项目</th>
                                        <th>检查周期</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>
                                            <label><input name="xzqt" type="checkbox"/>血脂全套</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="xzqtDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="qtgs" type="checkbox"/>躯体感受</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="qtgsDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="sgqt" type="checkbox"/>肾功全套</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="sgqtDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="ggqt" type="checkbox"/>肝功全套</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="ggqtDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="xcg" type="checkbox"/>血常规</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="xcgDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="thxhdb" type="checkbox"/>糖化血红蛋白</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="thxhdbDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="thbdb" type="checkbox"/>糖化白蛋白</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="thbdbDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="ncg" type="checkbox"/>尿常规</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="ncgDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="nbdb" type="checkbox"/>尿白蛋白肌酐比</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="nbdbDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="jg1" type="checkbox"/>甲功1</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="jg1Date" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="jg2" type="checkbox"/>甲功2</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="jg2Date" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="jg3" type="checkbox"/>甲功3</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="jg3Date" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="yd" type="checkbox"/>眼底</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="ydDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="abi" type="checkbox"/>ABI/TBI</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="abiDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="xzdmcs" type="checkbox"/>下肢动脉超声</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="xzdmcsDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="jzdmcs" type="checkbox"/>颈椎动脉超声</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="jzdmcsDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="mnxcs" type="checkbox"/>泌尿系超声</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="mnxcsDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="dnddlxdt" type="checkbox"/>电脑多导联心电图</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="dnddlxdtDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="fbcs" type="checkbox"/>腹部超声(肝胆胰脾)</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="fbcsDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="xhdb" type="checkbox"/>血红蛋白</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="xhdbDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="tnbxgkt" type="checkbox"/>1型糖尿病相关抗体</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="tnbxgktDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="ogtt" type="checkbox"/>OGTT实验</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="ogttDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>
                                            <label><input name="ct" type="checkbox"/>C肽</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="ctDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <label><input name="ins" type="checkbox"/>Ins</label>
                                        </td>
                                        <td class="input-td">
                                            <select name="insDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--添加的检查项目表格  start-->
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center addcheck-table">
                                    <thead>
                                    <tr>
                                        <th>检查项目</th>
                                        <th>检查周期</th>
                                        <th>操作</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>血脂全套</td>
                                        <td class="input-td">
                                            <select name="xzqtDate" class="form-control">
                                                <option value="1">1月</option>
                                                <option value="2">2月</option>
                                                <option value="3">3月</option>
                                                <option value="4">4月</option>
                                                <option value="5">5月</option>
                                                <option value="6">6月</option>
                                                <option value="7">7月</option>
                                                <option value="8">8月</option>
                                                <option value="9">9月</option>
                                                <option value="10">10月</option>
                                                <option value="11">11月</option>
                                                <option value="12">12月</option>
                                            </select>
                                        </td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <!--添加的检查项目表格  end-->
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-primary btn-outline btn-lg" data-toggle="modal" data-target="#addSolution">添加检查方案</button>
                            </div>
                        </div>
                        <div class="row margin-top-15 cl-baseMessage">
                            <div class="col-xs-4">
                                <span class="input-title">建议转诊</span>
                                <div class="input-content">
                                    <input type="text" name="department" class="form-control input-content-left" placeholder="请填写...">
                                    <span class="input-content-right">科</span>
                                </div>
                            </div>
                            <div class="col-xs-4 input-width-title">
                                <span class="input-title">治疗方案及处方</span>
                                <div class="input-content">
                                    <input type="text" name="isprescription" class="form-control input-content-left" placeholder="请填写...">
                                </div>
                            </div>
                            <div class="col-xs-4">
                                <span class="input-title">日期</span>
                                <div class="input-content">
                                    <input type="text" name="prescriptiondate" data-toggle="datepicker" class="form-control input-content-left" placeholder="请填写...">
                                </div>
                            </div>
                        </div>

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>治疗方案</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12 zlfa-radio">
                                <label><input type="radio" name="isunchanged" value="1" />曾用全部用药</label>
                                <label><input type="radio" name="isunchanged" value="2" />目前用药不变</label>
                                <label><input type="radio" checked name="isunchanged" value="3"/>修改用药方案</label>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center medicationList-table">
                                    <thead>
                                    <tr>
                                        <th>开始时间</th>
                                        <th>结束时间</th>
                                        <th>名称</th>
                                        <th>剂量</th>
                                        <th>单位</th>
                                        <th>用法</th>
                                        <th>频次</th>
                                        <th>其他备注</th>
                                        <th>操作</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>2017-06-02</td>
                                        <td>2017-06-02</td>
                                        <td>格华止</td>
                                        <td>9</td>
                                        <td>mg</td>
                                        <td>口服</td>
                                        <td>qd</td>
                                        <td>999</td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-primary" data-toggle="modal" data-target="#addMedication">编辑</button>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td>2017-06-02</td>
                                        <td>2017-06-02</td>
                                        <td>格华止</td>
                                        <td>9</td>
                                        <td>mg</td>
                                        <td>口服</td>
                                        <td>qd</td>
                                        <td>999</td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-primary" data-toggle="modal" data-target="#addMedication">编辑</button>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-outline btn-primary btn-lg" data-toggle="modal" data-target="#addMedication">添加用药</button>
                            </div>
                        </div>

                        <!--中医部分 start-->
                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>汤药详情</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <table class="table-bordered table-striped table-hover text-center tcm-table">
                                    <thead>
                                    <tr>
                                        <th>名称剂量</th>
                                        <th>煎服方法</th>
                                        <th>操作</th>
                                    </tr>
                                    </thead>
                                    <tbody>
                                    <tr>
                                        <td>闹羊花 1g</td>
                                        <td>煎法：水煎服 频次：一日一剂，两次分服 总数：3付</td>
                                        <td>
                                            <button type="button" class="btn btn-outline btn-primary" data-toggle="modal" data-target="#addTcm">编辑</button>
                                            <button type="button" class="btn btn-outline btn-danger">删除</button>
                                        </td>
                                    </tr>
                                    </tbody>
                                </table>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-outline btn-primary btn-lg" data-toggle="modal" data-target="#addTcm">添加汤药</button>
                            </div>
                        </div>
                        <!--中医部分 end-->

                        <div class="row margin-top-15">
                            <div class="col-xs-12 xbs-separated">
                                <span>上传医生电子签名</span>
                            </div>
                        </div>
                        <div class="row margin-top-15">
                            <div class="col-xs-12">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">放置上传按钮</button>
                            </div>
                        </div>

                        <!--备注-->
                        <div class="row margin-top-20">
                            <div class="col-xs-12 weight-change">
                                <span class="weight-title">备注信息</span>
                                <textarea name="" rows="10"></textarea>
                            </div>
                        </div>
                        <!--保存按钮-->
                        <div class="row margin-top-20">
                            <div class="col-xs-6 text-right">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存</button>
                            </div>
                            <div class="col-xs-6">
                                <button type="button" class="btn btn-outline btn-primary btn-lg">保存并下一步</button>
                            </div>
                        </div>
                    </div>
                </div>

                <!-- 添加症状Modal -->
                <div class="modal fade" id="addSymptom" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
                    <div class="modal-dialog" role="document">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                                <h3 class="modal-title" id="myModalLabel">
                                    选择主要症状
                                    <span class="text-muted symptom-text">最多可添加5项</span>
                                </h3>
                            </div>
                            <div class="modal-body">
                                <div class="addModel-group">
                                    <h4>最常见症状</h4>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="发现血糖升高" checked="checked">发现血糖升高 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="口干" checked="checked">口干 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="口渴" checked="checked">口渴 </label>
                                    </div>
                                    <div class="lable-item disabled">
                                        <label><input type="checkbox" value="多饮" disabled="disabled">多饮 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="多食" checked="checked">多食 </label>
                                    </div>
                                </div>
                                <div class="addModel-group">
                                    <h4>最常见症状</h4>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="发现血糖升高" checked="checked">发现血糖升高 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="口干" checked="checked">口干 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="口渴" checked="checked">口渴 </label>
                                    </div>
                                    <div class="lable-item disabled">
                                        <label><input type="checkbox" value="多饮" disabled="disabled">多饮 </label>
                                    </div>
                                    <div class="lable-item current">
                                        <label><input type="checkbox" value="多食" checked="checked">多食 </label>
                                    </div>
                                </div>
                            </div>
                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">取消</button>
                                <button type="button" class="btn btn-primary">添加</button>
                            </div>
                        </div>
                    </div>
                </div>
                <!-- 添加汤药Modal -->
                <div class="modal fade" id="addTcm" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
                    <div class="modal-dialog" role="document">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                                <h3 class="modal-title">
                                    添加汤药
                                </h3>
                            </div>
                            <div class="modal-body">
                                <div class="select-tcm">
                                    <div class="addModel-group">
                                        <h4 class="select-tcm-title">
                                            <span>选择药物</span>
                                            <div>
                                                <input type="text" name="tcm-search" class="form-control input-content" placeholder="请输入汤药关键字">
                                                <button type="button" class="btn btn-primary">搜索</button>
                                            </div>
                                        </h4>
                                        <div class="tcm-type">
                                            <div class="lable-item current">
                                                <label><input type="checkbox" value="寻骨风" checked="checked">寻骨风</label>
                                            </div>
                                            <div class="lable-item current">
                                                <label><input type="checkbox" value="口干" checked="checked">口干 </label>
                                            </div>
                                            <div class="lable-item current">
                                                <label><input type="checkbox" value="口渴" checked="checked">口渴 </label>
                                            </div>
                                            <div class="lable-item disabled">
                                                <label><input type="checkbox" value="多饮" disabled="disabled">多饮 </label>
                                            </div>
                                            <div class="lable-item current">
                                                <label><input type="checkbox" value="多食" checked="checked">多食 </label>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="input-tcm">
                                    <div class="selected-tcm-box padding-left-15 padding-right-15 padding-tb-10 margin-bottom-15">
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                        <div class="selected-tcm margin-bottom-10">
                                            <span>巡骨风</span>
                                            <input type="number" name="" class="form-control">g
                                        </div>
                                    </div>
                                    <div class="mess-box">
                                        <span>煎法</span>
                                        <div>
                                            <select class="form-control m-b input-content margin-bottom-0" name="tangyaoJianfa">
                                                <option value="水煎服">水煎服</option>
                                                <option value="冲服">冲服</option>
                                                <option value="泡服">泡服</option>
                                                <option value="包煎">包煎</option>
                                                <option value="另煎">另煎</option>
                                                <option value="熔化">熔化</option>
                                                <option value="煎汤代水">煎汤代水</option>
                                                <option value="先煎">先煎</option>
                                                <option value="后下">后下</option>
                                            </select>
                                        </div>
                                    </div>
                                    <div class="mess-box">
                                        <span>频次</span>
                                        <div class="input-two-select">
                                            <select class="form-control m-b input-content margin-bottom-0" name="tangyaoPinci1">
                                                <option value="1">一日一剂</option>
                                            </select>
                                            <select class="form-control m-b input-content margin-bottom-0" name="tangyaoPinci2">
                                                <option value="1">两次分服</option>
                                            </select>
                                        </div>
                                    </div>
                                    <div class="mess-box">
                                        <span>总数</span>
                                        <div class="input-two">
                                            <input type="text" name="fastingblood" class="form-control input-content">
                                            <span>付</span>
                                        </div>
                                    </div>
                                </div>

                            </div>
                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">取消</button>
                                <button type="button" class="btn btn-primary">添加</button>
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                        </div>
                    </div>
                </div>
                <!-- 添加诊断Modal -->
                <div class="modal fade" id="addDiagnosis" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
                    <div class="modal-dialog" role="document">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                                <h3 class="modal-title">
                                    添加诊断
                                </h3>
                            </div>
                            <div class="modal-body">
                                <div class="addDiagnosis-search">
                                    <input type="text" class="form-control" name="diagnosisName" placeholder="请输入搜索关键字">
                                    <button type="button" class="btn btn-outline btn-primary">搜索</button>
                                </div>
                                <div class="margin-top-15">
                                    <table class="table-bordered table-striped table-hover text-center addDiagnosis-table">
                                        <thead>
                                        <tr>
                                            <th></th>
                                            <th>诊断名称</th>
                                            <th>ICD编号</th>
                                        </tr>
                                        </thead>
                                        <tbody>
                                        <tr>
                                            <td><input type="checkbox" name="id[]"></td>
                                            <td>胰腺内分泌细胞增生伴有(胰)高血糖素分泌过多</td>
                                            <td>E1245667</td>
                                        </tr>
                                        <tr>
                                            <td><input type="checkbox" name="id[]"></td>
                                            <td>胰腺内分泌细胞增生伴有(胰)高血糖素分泌过多</td>
                                            <td>E1245667</td>
                                        </tr>
                                        <tr>
                                            <td><input type="checkbox" name="id[]"></td>
                                            <td>胰腺内分泌细胞增生伴有(胰)高血糖素分泌过多</td>
                                            <td>E1245667</td>
                                        </tr>
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">取消</button>
                                <button type="button" class="btn btn-primary">添加</button>
                            </div>
                        </div>
                    </div>
                </div>
                <!-- 添加检查方案Modal -->
                <div class="modal fade" id="addSolution" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
                    <div class="modal-dialog" role="document">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                                <h3 class="modal-title">
                                    添加检查方案
                                </h3>
                            </div>
                            <div class="modal-body">
                                <div class="modal-textarea-box">
                                    <span>方案名称</span>
                                    <input type="text" name="inspectionplanName" class="form-control" placeholder="请输入方案名称">
                                </div>
                            </div>
                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">取消</button>
                                <button type="button" class="btn btn-primary">添加</button>
                            </div>
                        </div>
                    </div>
                </div>
                <!-- 添加用药Modal -->
                <div class="modal fade" id="addMedication" tabindex="-1" role="dialog" aria-labelledby="myModalLabel">
                    <div class="modal-dialog" role="document">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
                                <h3 class="modal-title">
                                    添加用药详情
                                </h3>
                            </div>
                            <div class="modal-body">
                                <div class="mess-box">
                                    <span>服用药物</span>
                                    <div>
                                        <select class="form-control m-b input-content margin-bottom-0" name="drugsid">
                                            <option value="1">药品1</option>
                                            <option value="2">药品2</option>
                                            <option value="3">药品3</option>
                                            <option value="5">药品4</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>剂量</span>
                                    <div class="input-three">
                                        <select class="form-control m-b input-content margin-bottom-0 padding-left-5 padding-right-5" name="dosetype">
                                            <option value="1">每次剂量</option>
                                            <option value="2">分次剂量</option>
                                        </select>
                                        <input type="text" name="dose" class="form-control input-content">
                                        <select class="form-control m-b input-content margin-bottom-0" name="unit">
                                            <option value="mg">mg</option>
                                            <option value="g">g</option>
                                            <option value="u">u</option>
                                            <option value="ug">ug</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>开始时间</span>
                                    <div>
                                        <input type="text" name="drugsdate" class="form-control input-content" data-toggle="datepicker">
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>结束时间</span>
                                    <div>
                                        <input type="text" name="drugsenddate" class="form-control input-content" data-toggle="datepicker">
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>用法</span>
                                    <div>
                                        <select class="form-control m-b input-content margin-bottom-0" name="usage">
                                            <option value="1">口服</option>
                                            <option value="2">皮下注射</option>
                                            <option value="3">嚼服</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>频次</span>
                                    <div>
                                        <select class="form-control m-b input-content margin-bottom-0" name="frequency">
                                            <option value="qd">qd</option>
                                            <option value="Bid">Bid</option>
                                            <option value="Tid">Tid</option>
                                            <option value="qn">qn</option>
                                            <option value="Qid">Qid</option>
                                            <option value="Qod">Qod</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>患者用药</span>
                                    <div>
                                        <select class="form-control m-b input-content margin-bottom-0" name="islaw">
                                            <option value="规律" selected="">规律</option>
                                            <option value="不规律">不规律</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>症状</span>
                                    <div>
                                        <select class="form-control m-b input-content margin-bottom-0" name="isbetter">
                                            <option value="无变化" selected="">无变化</option>
                                            <option value="好转">好转</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>空腹血糖</span>
                                    <div class="input-two">
                                        <input type="text" name="fastingblood" class="form-control input-content">
                                        <span>mmol/L</span>
                                    </div>
                                </div>
                                <div class="mess-box">
                                    <span>餐后血糖</span>
                                    <div class="input-two">
                                        <input type="text" name="mealblood" class="form-control input-content">
                                        <span>mmol/L</span>
                                    </div>
                                </div>
                                <div class="modal-textarea-box">
                                    <span>其他备注</span>
                                    <textarea name="remark" rows="3"></textarea>
                                </div>
                            </div>
                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">取消</button>
                                <button type="button" class="btn btn-primary">添加</button>
                            </div>
                        </div>
                    </div>
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